Provider Demographics
NPI:1023059938
Name:OGDEN, JOSEPH DANIEL (CRNA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DANIEL
Last Name:OGDEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 HUNTERS HL STE 101
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-5306
Mailing Address - Country:US
Mailing Address - Phone:330-207-3347
Mailing Address - Fax:330-286-5396
Practice Address - Street 1:3685 HUNTERS HL
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-5306
Practice Address - Country:US
Practice Address - Phone:330-207-3347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN632594163W00000X
OHRN280986367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00082332OtherMEDICARE RAILROAD
OH2443332Medicaid
OHP00082332OtherMEDICARE RAILROAD