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General NPI Number Information
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NPI Number | 1225041320
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Entity Type | Individual
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Provider Name | JOHN GREGORY HOGUE PT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 550 CLUB LANE
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City | CONWAY
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State | AR
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Zip | 72034-3681
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Country | US
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Telephone | 501-513-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 550 CLUB LN STE 1
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City | CONWAY
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State | AR
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Zip | 72034-3681
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Country | US
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Telephone | 501-329-8069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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