Provider Demographics
NPI:1659562916
Name:RAMIREZ OCAMPO, JUAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:DAVID
Last Name:RAMIREZ OCAMPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JUAN
Other - Middle Name:D
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 960482
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0482
Mailing Address - Country:US
Mailing Address - Phone:405-844-1830
Mailing Address - Fax:405-341-9217
Practice Address - Street 1:1701 OAK PARK BLVD
Practice Address - Street 2:ER DEPT
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8911
Practice Address - Country:US
Practice Address - Phone:337-494-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD203127146D00000X
CO50584146D00000X
TXR2713207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine