Basic Information
| Provider Information | |||||||||
| NPI: | 1972542660 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGDEN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | SR. | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 CARONDELET DR | ||||||||
| Address2: | SUITE #220 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169411600 | ||||||||
| FaxNumber: | 8169411699 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 CARONDELET DR | ||||||||
| Address2: | SUITE #220 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169411600 | ||||||||
| FaxNumber: | 8169411699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 07/20/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DO R6B48 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00266243 | 01 | MO | RAILROAD MEDICARE | OTHER | 241628940 | 05 | MO | MEDICAID |