Healthcare Provider Details

I. General information

NPI: 1144401035
Provider Name (Legal Business Name): OGDEN FAMILY MEDICINE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8761 WEST CENTER ROAD
OMAHA NE
68124-2109
US

IV. Provider business mailing address

8761 WEST CENTER ROAD
OMAHA NE
68124-2109
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-6060
  • Fax: 402-398-0336
Mailing address:
  • Phone: 402-397-6060
  • Fax: 402-398-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number18975
License Number StateNE

VIII. Authorized Official

Name: KATHLEEN A OGDEN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 402-397-6060