Provider Demographics
NPI:1396199980
Name:OGDEN HEALTH
Entity Type:Organization
Organization Name:OGDEN HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MD
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-400-5988
Mailing Address - Street 1:62212 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-6136
Mailing Address - Country:US
Mailing Address - Phone:985-400-5988
Mailing Address - Fax:985-867-3644
Practice Address - Street 1:62212 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-6136
Practice Address - Country:US
Practice Address - Phone:985-400-5988
Practice Address - Fax:985-867-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206418207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2199587Medicaid
LA2199587Medicaid