Provider Demographics
NPI:1518931955
Name:OCHSNER, FREDERICK O (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:O
Last Name:OCHSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERCADO ST STE 160
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7309
Mailing Address - Country:US
Mailing Address - Phone:970-385-9850
Mailing Address - Fax:970-385-9854
Practice Address - Street 1:1 MERCADO ST STE 160
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7309
Practice Address - Country:US
Practice Address - Phone:970-385-9850
Practice Address - Fax:970-385-9854
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27813208M00000X
CODR.0027813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01278134Medicaid
E60277Medicare UPIN
802015Medicare ID - Type Unspecified