Individual
DR. PHILIP F GOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
505 BUCKEYE DR, TROY, IL 62294-2315
(314) 481-5000
(314) 481-3037
Mailing address
5203 CHIPPEWA ST, SUITE 301, SAINT LOUIS, MO 63109-2356
(314) 481-5000
(314) 481-3037
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
2005037958
MO
208D00000X
General Practice Physician
Primary
036114471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03611471
—
IL
01
—
431941391
TAX ID
MO
05
—
505738906
—
MO
Enumeration date
01/18/2006
Last updated
02/18/2011
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