Provider Demographics
NPI:1750386850
Name:OGDEN, JOHN G (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:G
Last Name:OGDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2141 S EDMONDS LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6162
Mailing Address - Country:US
Mailing Address - Phone:972-315-8500
Mailing Address - Fax:972-315-8512
Practice Address - Street 1:2141 S EDMONDS LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-6162
Practice Address - Country:US
Practice Address - Phone:972-315-8500
Practice Address - Fax:972-315-8512
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH9553208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics