Provider Demographics
NPI:1700401015
Name:HOGUE, FORREST JAMES
Entity type:Individual
Prefix:
First Name:FORREST
Middle Name:JAMES
Last Name:HOGUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MUSTANG ACRES
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-8039
Mailing Address - Country:US
Mailing Address - Phone:304-588-4011
Mailing Address - Fax:
Practice Address - Street 1:290 HANOVER ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-5034
Practice Address - Country:US
Practice Address - Phone:304-588-4011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2401235Z00000X
MA78583235Z00000X
WVSLP-2091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH78583Medicaid
MA78583Medicaid