Healthcare Provider Details

I. General information

NPI: 1023246386
Provider Name (Legal Business Name): TROY ROBERT OGDEN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 W. 6TH ST SUITE 100
RENO NV
89503-4549
US

IV. Provider business mailing address

236 W. 6TH ST SUITE 100
RENO NV
89503-4549
US

V. Phone/Fax

Practice location:
  • Phone: 775-322-4061
  • Fax: 775-322-6603
Mailing address:
  • Phone: 775-322-4061
  • Fax: 775-322-6603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number782
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: