Healthcare Provider Details

I. General information

NPI: 1306992920
Provider Name (Legal Business Name): PAUL OGDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S. HAVANA ST.
AURORA CO
80014-0001
US

IV. Provider business mailing address

2500 S. HAVANA ST.
AURORA CO
80014-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone: 303-338-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35994
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDR-35994
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: