Healthcare Provider Details

I. General information

NPI: 1477094779
Provider Name (Legal Business Name): ANGELLE AUBIN HOGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELLE AUBIN BILLIOT MD

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 RUE LOUIS XIV
LAFAYETTE LA
70508-5738
US

IV. Provider business mailing address

920 MADISON AVENUE SUITE 447
MEMPHIS TN
38163-3454
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-9700
  • Fax:
Mailing address:
  • Phone: 901-448-7635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number345995
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: