Doctor Name: | JENNIFER KIM BOGAN |
NPI Number: | 1720058001 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 29223 |
Business Practice Address: | 3331 N Elena Maria Tucson, AZ - 857502919 |
Business Phone Number: | 5209916480 |
Business Fax Number: | 5207956321 |
Mailing Address: | 3331 N Elena Maria, TUCSON |
State: | AZ |
Postal Code: | 857502919 |
Phone Number: | 5209916480 |
Fax Number: | 5207956321 |
NPI Enumeration Date: | 01/26/2006 |
NPI Last Update Date: | 10/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | 29223 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |