Individual
BOGAN M. MCQUIGG, III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
151 E REDSTONE AVE, CRESTVIEW, FL 32539-5352
(850) 936-1617
Mailing address
200 CORPORATE BLVD, SUITE 200, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102278
FL
Other
Enumeration date
05/14/2006
Last updated
04/09/2008
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