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NPI Code Detail

MEDICARE: JOHN M OGLE JR.

MEDICARE: JOHN M OGLE JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician200200429NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376515304
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN M OGLE JR.
Provider Business Mailing Address
First Line : 300 BETHESDA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-7218
Country : US
Telephone Number : 252-752-7141
Fax Number : 252-752-0223
Provider Business Practice Location Address
First Line : 300 BETHESDA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-7218
Country : US
Telephone Number : 252-752-7141
Fax Number : 252-752-0223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 06/20/2013

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