Provider Demographics
NPI:1639136450
Name:OGDEN, GERALD ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:ALAN
Last Name:OGDEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Mailing Address - Street 2:CMR 402 BOX 335
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:01149637-186-8288
Mailing Address - Fax:01149637-186-6193
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:CMR 402 BOX 335
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:01149637-186-8288
Practice Address - Fax:01149637-186-6193
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03281T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist