Basic Information
| Provider Information | |||||||||
| NPI: | 1871657882 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGDIE-BEATTY | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | RENAE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 SPRUCE STREET | ||||||||
| Address2: | 8 PENN TOWER, ROOM 828 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622454 | ||||||||
| FaxNumber: | 2156624500 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 SPRUCE STREET | ||||||||
| Address2: | 828 PENN TOWER | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191044206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156622454 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2006 | ||||||||
| LastUpdateDate: | 11/28/2011 | ||||||||
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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 | 207RR0500X | MD435426 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207R00000X | MT188567 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | MT188567 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.