Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 053061 | CO |
N | 207QA0401X | Family Doctor - Addiction Medicine | 0101270615 | VA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 53061 | CO |
N | 207QA0401X | Family Doctor - Addiction Medicine | D0090402 | MD |
N | 207QA0401X | Family Doctor - Addiction Medicine | IMLC.MD.61015852 | WA |
NPI | 1790984623 |
---|---|
Provider Name | Dr. Robert John Ochsner |
First Address | Colorado Springs, CO 80918-3684 |
Second Address | Colorado Springs, CO 80918-3684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2007 |
Last Update Date | 19/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
024662 | KAISER COMMERCIAL NUMBER (01) | CO |
11531517 | (05) | CO |