Healthcare Provider Details

I. General information

NPI: 1548499551
Provider Name (Legal Business Name): DR. ZACHARY PAUL OGDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2009
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 AUDUBON PLAZA DR SUITE 320
LOUISVILLE KY
40217-1300
US

IV. Provider business mailing address

3 AUDUBON PLAZA DR SUITE 320
LOUISVILLE KY
40217-1300
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-1844
  • Fax:
Mailing address:
  • Phone: 502-893-1844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00354
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: