Healthcare Provider Details

I. General information

NPI: 1720643687
Provider Name (Legal Business Name): NATHAN CHARLES HOGARTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10191 EVENDALE COMMONS DR
CINCINNATI OH
45241-2689
US

IV. Provider business mailing address

10191 EVENDALE COMMONS DR
CINCINNATI OH
45241-2689
US

V. Phone/Fax

Practice location:
  • Phone: 513-817-1170
  • Fax:
Mailing address:
  • Phone: 513-817-1170
  • Fax: 513-351-0316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35.155740
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: