Provider Demographics
NPI:1033109939
Name:OGLESBY, ALETHA CRESS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALETHA
Middle Name:CRESS
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9001 S 101ST EAST AVE
Mailing Address - Street 2:STE. 370
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5708
Mailing Address - Country:US
Mailing Address - Phone:918-392-7500
Mailing Address - Fax:918-254-2119
Practice Address - Street 1:3601 SW 160TH AVENUE
Practice Address - Street 2:SUITE 250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33024-6308
Practice Address - Country:US
Practice Address - Phone:877-866-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100252830AMedicaid
OK24M733006Medicare PIN
E16487Medicare UPIN