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General NPI Number Information
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NPI Number | 1215084660
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Entity Type | Organization
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Legal Business Name | ROBERT B OGESEN PC
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11011 S 48TH ST 200
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City | PHOENIX
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State | AZ
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Zip | 85044
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Country | US
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Telephone | 480-785-5769
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Fax | 480-785-8786
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Provider Business Mailing Address
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Address Line | 11011 S 48TH ST 200
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City | PHOENIX
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State | AZ
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Zip | 85044
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Country | US
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Telephone | 480-785-5769
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Fax | 480-785-8786
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. ROBERT BRUCE OGESEN II
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Credential | MD
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Telephone | 480-785-5769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20679
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License Number State | AZ
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