Healthcare Provider Details

I. General information

NPI: 1538182639
Provider Name (Legal Business Name): JUSTIN S OGDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 MCCLELLAND BLVD
JOPLIN MO
64804-1640
US

IV. Provider business mailing address

PO BOX 3810
JOPLIN MO
64803-3810
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-8400
  • Fax: 417-347-5709
Mailing address:
  • Phone: 417-347-8400
  • Fax: 417-347-5818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2006010642
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number04-45081
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: