Healthcare Provider Details

I. General information

NPI: 1518931955
Provider Name (Legal Business Name): FREDERICK O OCHSNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERCADO ST STE 160
DURANGO CO
81301-7309
US

IV. Provider business mailing address

1 MERCADO ST STE 160
DURANGO CO
81301-7309
US

V. Phone/Fax

Practice location:
  • Phone: 970-385-9850
  • Fax: 970-385-9854
Mailing address:
  • Phone: 970-385-9850
  • Fax: 970-385-9854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0027813
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number27813
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: