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NPI Code Detail

MEDICARE: DR. LAURA ANN HOGAN M.D.

MEDICARE: DR. LAURA ANN HOGAN 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
12085R0202XDiagnostic Radiology PhysicianME93731FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588647861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA ANN HOGAN M.D.
Provider Business Mailing Address
First Line : 5655 HUDSON DR STE 210
Second Line : ARIS RADIOLOGY
City : HUDSON
State : OH
Zip : 44236-4455
Country : US
Telephone Number : 330-655-1869
Fax Number : 330-655-3828
Provider Business Practice Location Address
First Line : 1906 BLAKE AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4227
Country : US
Telephone Number : 970-447-4065
Fax Number : 330-655-3828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 11/24/2021

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