MEDICARE: MS. DENISE MARIE OGDEN PAC

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	363A00000X	Physician Assistant	860	CO
2	363AM0700X	Medical Physician Assistant	860	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	860	OTHER	CO	BOARD OF ALEDICAL EXAMINE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922171016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE MARIE OGDEN PAC

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:	303-493-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7960 S UNIVERSITY BLVD STE 101
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-3167
Country	:	US
Telephone Number	:	303-788-3100
Fax Number	:	303-788-3197

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	11/20/2018

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