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General NPI Number Information
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NPI Number | 1881759744
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Entity Type | Individual
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Provider Name | CHRISTOPHER HOGAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 5023 MUD LN 110
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City | LOUISVILLE
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State | KY
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Zip | 40229-2800
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Country | US
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Telephone | 502-968-2015
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Fax | 502-964-1915
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Provider Business Mailing Address
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Address Line | 4000 POPLAR LEVEL RD
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City | LOUISVILLE
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State | KY
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Zip | 40213-1524
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Country | US
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Telephone | 502-459-2020
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Fax | 502-456-5925
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1567DT
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License Number State | KY
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