Provider Demographics
NPI:1255024568
Name:OGLE, NATALIE
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:OGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 WOODRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-1603
Mailing Address - Country:US
Mailing Address - Phone:812-430-6293
Mailing Address - Fax:
Practice Address - Street 1:800 N GREEN RIVER RD SPC 205
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2471
Practice Address - Country:US
Practice Address - Phone:812-475-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004397A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty