Provider Demographics
NPI:1922008929
Name:OGGEL, JAMES DEAN (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DEAN
Last Name:OGGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4280 SERGEANT RD
Mailing Address - Street 2:#230
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4634
Mailing Address - Country:US
Mailing Address - Phone:712-274-6884
Mailing Address - Fax:712-274-6885
Practice Address - Street 1:4280 SERGEANT RD
Practice Address - Street 2:#230
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4634
Practice Address - Country:US
Practice Address - Phone:712-274-6884
Practice Address - Fax:712-274-6885
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23362207K00000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0203331Medicaid
IAA02168Medicare UPIN
IA0203331Medicaid
SDS42026Medicare ID - Type Unspecified