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NPI Code Detail

MEDICARE: DR. CASEY ANNE HOGAN D.M.D.

MEDICARE: DR. CASEY ANNE HOGAN D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry11161KY

General Provider Information

NPI Number : 1174364830
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CASEY ANNE HOGAN D.M.D.
Provider Business Mailing Address
First Line : 101 STATE AVE
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1448
Country : US
Telephone Number : 270-651-5939
Fax Number :
Provider Business Practice Location Address
First Line : 101 STATE AVE
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1448
Country : US
Telephone Number : 270-651-5939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2024
Last Update Date : 06/05/2024

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