Healthcare Provider Details

I. General information

NPI: 1801811237
Provider Name (Legal Business Name): VAL Y VOGT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 WOLF PARK DR STE 102
GERMANTOWN TN
38138-1759
US

IV. Provider business mailing address

1325 WOLF PARK DR STE 103
GERMANTOWN TN
38138-1759
US

V. Phone/Fax

Practice location:
  • Phone: 901-252-3400
  • Fax: 901-763-4305
Mailing address:
  • Phone: 901-252-3411
  • Fax: 901-763-4305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number29404
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: