Individual
THOMAS J. HOGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4425 PAULSEN ST, BLDG. A 1ST FLOOR, SAVANNAH, GA 31405-3662
(912) 350-6000
(912) 350-6001
Mailing address
6602 WATERS AVE BLDG A, SAVANNAH, GA 31406-2778
(912) 350-6000
(912) 350-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040099
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000680325C
—
GA
05
—
000680325D
—
GA
05
—
000680325E
—
GA
01
—
10065723
AMERIGROUP
GA
01
—
110214365
RR MEDICARE
GA
01
—
349783
WELLCARE
GA
01
—
619196
WELLCARE
GA
05
—
G40099
—
SC
Enumeration date
06/08/2006
Last updated
01/04/2022
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