Individual
LATRICE M HOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1550 MULKEY RD, AUSTELL, GA 30106-1112
(770) 732-1137
(770) 732-2081
Mailing address
1550 MULKEY RD, AUSTELL, GA 30106-1112
(770) 732-1137
(770) 732-2081
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2023-01673
NC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
97905
GA
207NS0135X
Procedural Dermatology Physician
2023-01673
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
03/04/2025
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