Provider Demographics
NPI:1174506463
Name:HOGAN, WILLIAM ESTES JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ESTES
Last Name:HOGAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:715 S TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3237
Mailing Address - Country:US
Mailing Address - Phone:419-334-6661
Mailing Address - Fax:419-334-6685
Practice Address - Street 1:715 S TAFT AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3296
Practice Address - Country:US
Practice Address - Phone:419-334-6639
Practice Address - Fax:419-333-2793
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-092119207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2890199Medicaid
OHH229382Medicare UPIN
FLI17513Medicare UPIN
OH2890199Medicaid
OHH229382Medicare PIN