MEDICARE: JOHN G. OGDEN M.D.

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	208000000X	Pediatrics Physician	H9553	TX

General Provider Information

NPI Number	:	1750386850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN G. OGDEN M.D.

Provider Business Mailing Address
First Line	:	2141 S EDMONDS LN
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-6162
Country	:	US
Telephone Number	:	972-315-8500
Fax Number	:	972-315-8512

Provider Business Practice Location Address
First Line	:	2141 S EDMONDS LN
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-6162
Country	:	US
Telephone Number	:	972-315-8500
Fax Number	:	972-315-8512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	01/21/2014

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