Mogle, Douglas J

Mogle, Douglas J is an individual health care provider with primary practice located at 1350 Hickory St , Melbourne FL 32901-3224. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Mogle, Douglas J can be contacted via phone (321) 434-1771.

Contact Information

Primary practice address
1350 Hickory St Melbourne FL 32901-3224
Fax: (321) 434-1775
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X ME45551 Florida

Profile Details

NPI number 1295717528
LBN Legal business name Mogle, Douglas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated Jul 31st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295717528 NPPES
Florida Other 130014007 RR MEDICARE
Florida MEDICAID 040872700 RR MEDICARE

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