Individual
DR. JULIE D BOGDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
341 OZONA RD, PICAYUNE, MS 39466-7819
(601) 749-1502
Mailing address
341 OZONA RD, PICAYUNE, MS 39466-7819
(601) 749-1502
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00227
MS
363AM0700X
Medical Physician Assistant
PA.A10440.RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1628603
—
LA
05
—
PA00227
—
MS
Enumeration date
04/25/2006
Last updated
05/10/2023
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