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Individual

LORI L JOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
500 LONDON AVE, MARYSVILLE, OH 43040-5512
(937) 644-6115
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35078162J
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000315466
BCBS
05
2199866
OH
01
P00086284
RAIL ROAD MEDICARE
Enumeration date
05/11/2006
Last updated
10/18/2007
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