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NPI Code Detail

MEDICARE: DR. RONALD NELSON OGLESBY D.O.

MEDICARE: DR. RONALD NELSON OGLESBY D.O.
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
1207Q00000XFamily Medicine Physician2888OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578595955
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD NELSON OGLESBY D.O.
Provider Business Mailing Address
First Line : 1551 N 9TH ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-8898
Country : US
Telephone Number : 918-355-7949
Fax Number : 918-355-7909
Provider Business Practice Location Address
First Line : 1551 NORTH 9TH STREET
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-8898
Country : US
Telephone Number : 918-355-7949
Fax Number : 918-355-7909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 05/06/2014

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