Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | MD61232104 | WA |
N | 2080P0214X | Pediatric Pulmonologist | MED-PHYS-LIC-99537 | MT |
N | 2080P0214X | Pediatric Pulmonologist | Q0527 | TX |
N | 208D00000X | General Practice Physician | MED-PHYS-LIC-99537 | MT |
N | 208D00000X | General Practice Physician | Q0527 | TX |
NPI | 1508031956 |
---|---|
Provider Name | Arthur Chester Ogborn JR. |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Brownsville, TX 78520-7535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 02/11/2021 |