Basic Information
| Provider Information | |||||||||
| NPI: | 1003153834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VONHOEGEN | ||||||||
| FirstName: | JAN | ||||||||
| MiddleName: | KENJIRO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2316 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352332414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053297519 | ||||||||
| FaxNumber: | 2053297536 | ||||||||
| Practice Location | |||||||||
| Address1: | 720 MONTCLAIR RD | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352131964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053975200 | ||||||||
| FaxNumber: | 2053975220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2013 | ||||||||
| LastUpdateDate: | 01/14/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | L3723F | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.