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General NPI Number Information
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NPI Number | 1255509873
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Entity Type | Individual
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Provider Name | BERNARD OKEM OGON M.D
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Gender | Male
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Dates
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Enumeration Date | 02/16/2008
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 583 SHOEMAKER ROAD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4201
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Country | US
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Telephone | 484-378-2424
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Fax | 484-723-5324
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Provider Business Mailing Address
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Address Line | 583 SHOEMAKER ROAD
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4201
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Country | US
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Telephone | 484-378-2424
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Fax | 484-723-5324
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 25MA08756900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MD436175
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License Number State | PA
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