Provider Demographics
NPI:1124727995
Name:VOGEL, THOMAS JACOB
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JACOB
Last Name:VOGEL
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 1:6623 ERASTUS DURBIN RD
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-9249
Mailing Address - Country:US
Mailing Address - Phone:419-733-0768
Mailing Address - Fax:
Practice Address - Street 1:6623 ERASTUS DURBIN RD
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-9249
Practice Address - Country:US
Practice Address - Phone:419-733-0768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant