Healthcare Provider Details

I. General information

NPI: 1609367986
Provider Name (Legal Business Name): DAVID BRENDON VOGEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 11/18/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 JOHNSTON MEMORIAL DR
ABINGDON VA
24211-7664
US

IV. Provider business mailing address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

V. Phone/Fax

Practice location:
  • Phone: 276-258-4435
  • Fax:
Mailing address:
  • Phone: 276-258-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberUO8741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: