Provider Demographics
NPI:1588691091
Name:FROGGATT, JOHN W III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:FROGGATT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1234 NAPIER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2112
Mailing Address - Country:US
Mailing Address - Phone:269-985-4632
Mailing Address - Fax:269-985-4535
Practice Address - Street 1:1234 NAPIER AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2112
Practice Address - Country:US
Practice Address - Phone:269-985-4632
Practice Address - Fax:269-985-4535
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-05-02
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301073475207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110203683OtherRAILROAD MEDICARE
MI4401102601OtherBLUE CROSS
MI7501303OtherCIGNA
MI4382637Medicaid
MI1538397120OtherGROUP NPI
MI92-30009OtherPHP
MI270381199OtherTAX ID
MI7501303OtherCIGNA
MIBF6181731OtherDEA
MI92-30009OtherPHP