Healthcare Provider Details

I. General information

NPI: 1942793385
Provider Name (Legal Business Name): HANNAH VOGT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 WATSON ST STE 200
PRATT KS
67124-3092
US

IV. Provider business mailing address

203 WATSON ST STE 200
PRATT KS
67124-3092
US

V. Phone/Fax

Practice location:
  • Phone: 620-672-7422
  • Fax: 855-881-8481
Mailing address:
  • Phone: 620-672-7422
  • Fax: 855-881-8481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number94-09477
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: