| |
3711 Chandler Rd, Muskogee, OK 74403-4930 | |
(918) 686-6932 | |
(539) 313-9092 |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner - Family |
Location | 3711 Chandler Rd, Muskogee, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982827309 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Jimmy Keith Ogden |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1548370646 PECOS PAC ID: 9931364908 Enrollment ID: I20120626000565 |
Mailing Address | Practice Location Address |
---|---|
3711 Chandler Rd, Muskogee, OK 74403-4930 Ph: (918) 686-6932 | 3711 Chandler Rd, Muskogee, OK 74403-4930 Ph: (918) 686-6932 |