MEDICARE: DR. LINDA K OGE 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	10050R	LA

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	080070939	OTHER	LA	PALMETTO GBA - RAILROAD M

General Provider Information

NPI Number	:	1801894217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA K OGE M.D.

Provider Business Mailing Address
First Line	:	4212 W CONGRESS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-6765
Country	:	US
Telephone Number	:	337-988-8811
Fax Number	:	337-988-8844

Provider Business Practice Location Address
First Line	:	4212 W CONGRESS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-6765
Country	:	US
Telephone Number	:	337-988-8811
Fax Number	:	337-988-8844

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

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	02/27/2008

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