MEDICARE: MR. ROBERT JOHNSTON VOGEL PA-C

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
1	363A00000X	Physician Assistant	044	WY

General Provider Information

NPI Number	:	1386734812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT JOHNSTON VOGEL PA-C

Provider Business Mailing Address
First Line	:	900 CY AVE
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-4174
Country	:	US
Telephone Number	:	307-237-2273
Fax Number	:	307-472-7150

Provider Business Practice Location Address
First Line	:	900 CY AVE
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-4174
Country	:	US
Telephone Number	:	307-237-2273
Fax Number	:	307-472-7150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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