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General NPI Number Information
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NPI Number | 1245761030
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Entity Type | Individual
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Provider Name | ELIZABETH BROOKS HOGAN D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 310 N L ROGERS WELLS BLVD
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City | GLASGOW
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State | KY
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Zip | 42141-1300
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Country | US
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Telephone | 502-651-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 310 N L ROGERS WELLS BLVD
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City | GLASGOW
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State | KY
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Zip | 42141-1300
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Country | US
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Telephone | 270-659-5885
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Fax | 270-659-5852
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 04705
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License Number State | KY
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