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General NPI Number Information
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NPI Number | 1821041856
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Entity Type | Organization
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Legal Business Name | THOMAS J HOGARTY, M.D.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 206 N BROOKS ST
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City | SHERIDAN
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State | WY
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Zip | 82801-3801
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Country | US
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Telephone | 307-672-8941
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Fax | 307-672-7461
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Provider Business Mailing Address
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Address Line | 206 N BROOKS ST
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City | SHERIDAN
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State | WY
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Zip | 82801-3801
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Country | US
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Telephone | 307-672-8941
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Fax | 307-672-7461
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS JOSEPH HOGARTY
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Credential | M.D.
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Telephone | 307-672-8941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2751A
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License Number State | WY
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