DR. DANA JUNE HOGAN MD NPI 1578555876

NPI Information

NPI: 1578555876
Provider Name: DR. DANA JUNE HOGAN, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 11D0955700

Address:
1160 CAPITAL AVE STE 105
WATKINSVILLE, GA
ZIP 30677
Phone: (706) 769-9410
Get Directions

DR. Dana June Hogan, MD is a pediatrics in Watkinsville, GA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Dana June Hogan, MD NPI is 1578555876. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1160 CAPITAL AVE STE 105
WATKINSVILLE, GA
ZIP 30677-832
Phone: (706) 769-9410
Fax: (706) 769-9475

The CLIA number assigned to this NPI record is 11D0955700 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2005 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		044236	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000755961E	MEDICAID	GEORGIA
2	000755961G	MEDICAID	GEORGIA
3	044236	OTHER	GEORGIA	MEDICAL LISCENSE
4	1578555876	OTHER		INDIVIDUAL NPI
5	1138488848	OTHER		GROUP NPI
6	582560190	OTHER	GEORGIA	TAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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