Healthcare Provider Details

I. General information

NPI: 1376840348
Provider Name (Legal Business Name): LEIGH ANN D. HOGG NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEIGH ANN DAVIDSON RNFA

II. Dates (important events)

Enumeration Date: 02/27/2011
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 13TH ST SUITE 20
AUGUSTA GA
30901-2668
US

IV. Provider business mailing address

811 13TH ST SUITE 20
AUGUSTA GA
30901-2668
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-3401
  • Fax: 706-724-6540
Mailing address:
  • Phone: 706-722-3401
  • Fax: 706-724-6540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN134384
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: