Healthcare Provider Details

I. General information

NPI: 1386061257
Provider Name (Legal Business Name): LAUREN MARIE OGRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8841 E BELL RD STE 201
SCOTTSDALE AZ
85260-1984
US

IV. Provider business mailing address

8841 E BELL RD STE 201
SCOTTSDALE AZ
85260-1984
US

V. Phone/Fax

Practice location:
  • Phone: 480-398-1550
  • Fax: 480-398-1551
Mailing address:
  • Phone: 480-398-1550
  • Fax: 480-398-1551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number57595
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: