Individual
FREDERICK JOSEPH KOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6707 N 19TH AVE, SUITE 200, PHOENIX, AZ 85015-1104
(602) 249-4750
(602) 249-4814
Mailing address
14410 N. 14TH ST., PHOENIX, AZ 85022-4446
(602) 375-1433
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12265
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241703
—
AZ
Enumeration date
05/30/2006
Last updated
04/20/2022
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