MEDICARE: DR. ROBERT JOHN OCHSNER 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	207Q00000X	Family Medicine Physician	053061	CO
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	IMLC.MD.61015852	WA
3	207QA0401X	Addiction Medicine (Family Medicine) Physician	0101270615	VA
4	207QA0401X	Addiction Medicine (Family Medicine) Physician	D0090402	MD
5	207QA0401X	Addiction Medicine (Family Medicine) Physician	53061	CO
6	207QA0401X	Addiction Medicine (Family Medicine) Physician	036160445	IL

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
2	024662	OTHER	CO	KAISER COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1790984623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JOHN OCHSNER M.D.

Provider Business Mailing Address
First Line	:	5731 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-3684
Country	:	US
Telephone Number	:	719-445-3260
Fax Number	:

Provider Business Practice Location Address
First Line	:	5731 N ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-3684
Country	:	US
Telephone Number	:	719-445-3260
Fax Number	:

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	03/22/2023

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