Basic Information
| Provider Information | |||||||||
| NPI: | 1437412210 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGDEN-MCKEE | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 W EAGLE DR | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762343745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406277440 | ||||||||
| FaxNumber: | 9406277464 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 W EAGLE DR | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762343745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406277440 | ||||||||
| FaxNumber: | 9406277464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2012 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | PA07911 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | PA07911 | 01 | TX | MEDICAL LICENSE | OTHER |