Healthcare Provider Details

I. General information

NPI: 1447474143
Provider Name (Legal Business Name): DONN M HOGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9746 N 90TH PL STE 205
SCOTTSDALE AZ
85258-5085
US

IV. Provider business mailing address

2149 E WARNER ROAD SUITE 102
TEMPE AZ
85284
US

V. Phone/Fax

Practice location:
  • Phone: 480-610-6100
  • Fax: 480-767-2716
Mailing address:
  • Phone: 480-610-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number36903
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: