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General NPI Number Information
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NPI Number | 1447415658
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Entity Type | Organization
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Legal Business Name | WILLIAM J. GOGAN, MD PA
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 02/15/2013
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Provider Practice Location Address
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Address Line | 701 NORTHLAKE BLVD SUITE 208
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City | N PALM BEACH
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State | FL
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Zip | 33408-5215
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Country | US
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Telephone | 561-848-7768
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Fax |
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Provider Business Mailing Address
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Address Line | 701 NORTHLAKE BLVD SUITE 208
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City | N PALM BEACH
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State | FL
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Zip | 33408-5215
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Country | US
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Telephone | 561-848-7768
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM J. GOGAN
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Credential | M.D
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Telephone | 561-848-7768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0058162
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License Number State | FL
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