| Doctor Name: | DR. DOUGLAS R HOGOBOOM |
| NPI Number: | 1083979801 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 1144 |
| Business Practice Address: | Wiesbaden Health Clinic, Unit 29623 Apo, AE - 09096 |
| Business Phone Number: | 0637194645762 |
| Business Fax Number: | |
| Mailing Address: | Wiesbaden Health Clinic, Unit 29623, APO |
| State: | AE |
| Postal Code: | 09096 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2012 |
| NPI Last Update Date: | 05/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1144 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |