Individual
DONALD E BOGARD II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2350 MIAMI VALLEY DR STE 500, CENTERVILLE, OH 45459-4780
(937) 425-0003
(937) 245-6308
Mailing address
6680 POE AVE, SUITE 200, DAYTON, OH 45414-2854
(937) 280-8400
(937) 280-8373
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-000768
OH
363AS0400X
Surgical Physician Assistant
50-00-0768
OH
Other
Enumeration date
08/09/2005
Last updated
12/29/2020
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