Provider Demographics
NPI:1356546865
Name:HOGGATT, DOUGLAS WINSTON (PT)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:WINSTON
Last Name:HOGGATT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9483 W SHELBORNE DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-5597
Mailing Address - Country:US
Mailing Address - Phone:208-377-1900
Mailing Address - Fax:208-377-1905
Practice Address - Street 1:502 N KIMBALL PL
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-0608
Practice Address - Country:US
Practice Address - Phone:208-377-1900
Practice Address - Fax:208-377-1905
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDPT-15482251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics