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Individual

DR. CHRISTOPHER TARO HOGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
305 W JACKSON ST STE 206, CARBONDALE, IL 62901-1474
(618) 457-3006
(618) 457-3008
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
02003449A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
036108946
IL
207X00000X
Orthopaedic Surgery Physician
20A17676
CA
207X00000X
Orthopaedic Surgery Physician
5101022183
MI
207XX0801X
Orthopaedic Trauma Physician
036108946
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000844180
ANTHEM
IN
05
036108946
IL
05
201200480
IN
Enumeration date
07/05/2006
Last updated
07/21/2022
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