Healthcare Provider Details

I. General information

NPI: 1598861239
Provider Name (Legal Business Name): MOIRA LYNN OGDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HIGHWAY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

1514 JEFFERSON HIGHWAY
NEW ORLEANS LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-7518
  • Fax: 985-873-9997
Mailing address:
  • Phone: 504-842-4000
  • Fax: 985-873-9997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.023805
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number023805
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number023805
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: