Hogan, Bennett P

Hogan, Bennett P is an sole proprietor health care provider with primary practice located at 117 W Northside Dr , Valdosta GA 31602-1700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hogan, Bennett P can be contacted via phone (229) 333-0616.

Contact Information

Primary practice address
117 W Northside Dr Valdosta GA 31602-1700
Phone: (229) 333-0616
Fax: (229) 333-0647
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 050024 Georgia

Profile Details

NPI number 1205891397
LBN Legal business name Hogan, Bennett P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2006
Last updated Jun 27th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205891397 NPPES
Georgia MEDICAID 000906177A

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