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NPI Code Detail

MEDICARE: BRUCE A OGG

MEDICARE: BRUCE A OGG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician25452AZ

General Provider Information

NPI Number : 1275585440
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE A OGG
Provider Business Mailing Address
First Line : 6208 N CAMINO DE COROZAL
Second Line :
City : TUCSON
State : AZ
Zip : 85704-1081
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 W REX ALLEN DR
Second Line :
City : WILLCOX
State : AZ
Zip : 85643-1009
Country : US
Telephone Number : 800-444-7009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 07/08/2007

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Directions to “ BRUCE A OGG ” Practice Location

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