Basic Information
Provider Information
NPI: 1184690562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOGEL
FirstName: JOSEPH
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 86430
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571186430
CountryCode: US
TelephoneNumber: 6053224900
FaxNumber: 6053224910
Practice Location
Address1: 6215 S CLIFF AVE
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571088596
CountryCode: US
TelephoneNumber: 6053223300
FaxNumber: 6053223301
Other Information
ProviderEnumerationDate: 02/27/2006
LastUpdateDate: 08/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X8100SDY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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