Individual
THOMAS ROY HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Mailing address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-2884
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R7238
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002739110
MEDICARE RAILROAD
WI
Enumeration date
05/21/2007
Last updated
11/12/2009
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