Provider Demographics
NPI:1174957245
Name:HOGUE, PAMELA H (MSOTR)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:H
Last Name:HOGUE
Suffix:
Gender:F
Credentials:MSOTR
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:MOYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR
Mailing Address - Street 1:2823 GREYSTONE COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-5400
Practice Address - Country:US
Practice Address - Phone:205-387-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
AL3997225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3997OtherLICENSE