Healthcare Provider Details

I. General information

NPI: 1396199980
Provider Name (Legal Business Name): OGDEN HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62212 RAYMOND RD
LACOMBE LA
70445-6136
US

IV. Provider business mailing address

62212 RAYMOND RD
LACOMBE LA
70445-6136
US

V. Phone/Fax

Practice location:
  • Phone: 985-400-5988
  • Fax: 985-867-3644
Mailing address:
  • Phone: 985-400-5988
  • Fax: 985-867-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.206418
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.206418
License Number StateLA

VIII. Authorized Official

Name: STEVEN OGDEN
Title or Position: OWNER / MD
Credential: MD
Phone: 985-400-5988