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General NPI Number Information
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NPI Number | 1417950833
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Entity Type | Individual
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Provider Name | CHRISTOPHER D HOGAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 351 COWAN RD
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City | GULFPORT
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State | MS
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Zip | 39507-2019
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Country | US
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Telephone | 228-896-1120
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Fax | 228-896-1332
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Provider Business Mailing Address
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Address Line | 243 CHARLES ST
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City | BOSTON
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State | MA
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Zip | 02114-3002
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Country | US
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Telephone |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 1020356
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 14349
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License Number State | MS
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