Provider Demographics
NPI:1043509714
Name:GOGEL, KACI ELIZABETH (MD)
Entity type:Individual
Prefix:MISS
First Name:KACI
Middle Name:ELIZABETH
Last Name:GOGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:123 W GORDON ST APT C
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4994
Mailing Address - Country:US
Mailing Address - Phone:812-686-1187
Mailing Address - Fax:
Practice Address - Street 1:600 GRESHAM DR RM 304
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-3397
Practice Address - Fax:757-388-2885
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA72161207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine