Provider Demographics
NPI:1235164369
Name:OGDEN, PATRICK O (DO)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:O
Last Name:OGDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:215-807-8235
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007717L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6946513OtherCIGNA
PA0014634280009Medicaid
PA0704701000OtherKEYSTONE IBC
PA1012424OtherKEYSTONE MERCY
PA01463428-03OtherAMERICHOICE
PA761218OtherHIGHMARK BLUE SHIELD
PA0014634280008Medicaid
PA2968422OtherAETNA CONTRACT
PA761218OtherPERSONAL CHOICE
PA28898OtherHEALTH PARTNERS
PA0014634280007Medicaid
PA0014634280007Medicaid