Basic Information
| Provider Information | |||||||||
| NPI: | 1659562916 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMIREZ OCAMPO | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RAMIREZ | ||||||||
| OtherFirstName: | JUAN | ||||||||
| OtherMiddleName: | D | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 960482 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731960482 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058441830 | ||||||||
| FaxNumber: | 4053419217 | ||||||||
| Practice Location | |||||||||
| Address1: | 1701 OAK PARK BLVD | ||||||||
| Address2: | ER DEPT | ||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706018911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374943036 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2007 | ||||||||
| LastUpdateDate: | 07/14/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 146D00000X | MD203127 | LA | Y | Emergency Medical Service Providers | Personal Emergency Response Attendant | 146D00000X | 50584 | CO | N | Emergency Medical Service Providers | Personal Emergency Response Attendant | 207P00000X | R2713 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.