Individual
WILLIAM E HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
(208) 239-2110
Mailing address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
(208) 239-2110
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-3351
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003746700
—
ID
Enumeration date
02/13/2009
Last updated
02/13/2009
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