MEDICARE: N.D. OGLESBEE, O.D., INC.

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
1	152W00000X	Optometrist	18001832B	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1518060151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N.D. OGLESBEE, O.D., INC.

Provider Business Mailing Address
First Line	:	207 EAST MARKET STREET
Second Line	:
City	:	NAPPANEE
State	:	IN
Zip	:	46550
Country	:	US
Telephone Number	:	574-773-4732
Fax Number	:	574-773-2164

Provider Business Practice Location Address
First Line	:	207 E MARKET ST
Second Line	:
City	:	NAPPANEE
State	:	IN
Zip	:	46550-2119
Country	:	US
Telephone Number	:	574-773-4732
Fax Number	:	574-773-2164

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NATHANAEL D OGLESBEE
Credential	:	O.D.
Telephone Number	:	574-773-4732

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	04/22/2008

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