Individual
DR. ROGER OHANES OGHLAKIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2115 S FREMONT AVE, STE 3000, SPRINGFIELD, MO 65804-2239
(417) 820-9123
(417) 820-3935
Mailing address
2115 S FREMONT AVE STE 3000, SPRINGFIELD, MO 65804-2215
(417) 829-9123
(417) 820-3935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.011624
OH
2084N0400X
Neurology Physician
Primary
2011003940
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245449461
—
MO
05
—
187910001
—
AR
01
—
431560263
TRICARE
MO
01
—
P00954926
RR MCR
MO
Enumeration date
05/22/2007
Last updated
09/08/2023
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