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Organization
SUNSHINE PEDIATRICS PC
Active
Organization
SUNSHINE PEDIATRICS PC
Active
Other names
Dana J Hogan MD
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN NOVA QUINN-JACKSON (OFFICE MANAGER)
(706) 769-9410
Entity
Organization
Contact information
Practice address
1160 CAPITAL AVE, SUITE 105, WATKINSVILLE, GA 30677-1832
(706) 769-9410
(706) 769-9475
Mailing address
1160 CAPITAL AVE STE 105, P O BOX 1379, WATKINSVILLE, GA 30677-1832
(706) 769-9410
(706) 769-9475
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
044236
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000096226
GHP PROVIDER REF#
GA
01
—
0005703737
AETNA PIN #
GA
05
—
000755961E
—
GA
01
—
044236
GEORGIA MEDICAL LIC NUMBE
GA
01
—
10033203
AMERIGROUP COMM CARE PROV
GA
01
—
106027
PEACHSTATE PROVIDER NUMBER
GA
01
—
1578555876
DANA J HOGAN MD NPI
GA
01
—
526365270003
BCBS PROVIDER ID
GA
05
—
658251501A
—
GA
Enumeration date
12/08/2006
Last updated
03/07/2023
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