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Individual

MR. JACK BOGART JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
3 HOSPITAL DR STE 206, LEWISBURG, PA 17837-9394
(570) 524-4141
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP011577
PA
363LC0200X
Critical Care Medicine Nurse Practitioner
SP011577
PA

Other

Enumeration date
08/29/2011
Last updated
11/28/2025
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