Provider Demographics
NPI:1740315951
Name:OGUREK, JAMES C (NBC-HIS STATE LICENS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:OGUREK
Suffix:
Gender:M
Credentials:NBC-HIS STATE LICENS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 GRAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403
Mailing Address - Country:US
Mailing Address - Phone:715-842-9882
Mailing Address - Fax:715-848-0659
Practice Address - Street 1:330 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403
Practice Address - Country:US
Practice Address - Phone:715-842-9882
Practice Address - Fax:715-848-0659
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI298237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist