Brogan, Theodore W
Brogan, Theodore W is an individual health care provider with primary practice located at 3611 S Reed Rd Ste 213, Kokomo IN 46902-3806. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Brogan, Theodore W can be contacted via phone (765) 865-6076.Contact Information
Primary practice address
3611 S Reed Rd Ste 213
Kokomo IN 46902-3806
Phone: (765) 865-6076
Fax: (765) 865-6077
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 01048142 | Indiana |
Profile Details
| NPI number | 1639173438 |
|---|---|
| LBN Legal business name | Brogan, Theodore W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Nov 27th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639173438 | NPPES |
| Indiana | MEDICAID | 200188340 | |
| Indiana | Other | 000000557418 |
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