Provider Demographics
NPI:1063218048
Name:VOGLER, JOHN WILBUR IV (PA-S2)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILBUR
Last Name:VOGLER
Suffix:IV
Gender:
Credentials:PA-S2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MAPLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-7403
Mailing Address - Country:US
Mailing Address - Phone:828-974-6174
Mailing Address - Fax:
Practice Address - Street 1:145 MAPLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-7403
Practice Address - Country:US
Practice Address - Phone:828-974-6174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCVOGL-IV6QZT363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant