Individual
MR. SAMUEL LANCE OGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1601 NEW CASTLE RD, FORREST CITY, AR 72335-2218
(870) 261-0513
(870) 261-0535
Mailing address
PO BOX 771522, MEMPHIS, TN 38177-1522
(901) 747-4624
(901) 261-2542
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00837
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122249701
—
AR
01
—
1710946736
BAPTIST HEALTH SERVICES GROUP, INC.
AR
01
—
5S391
ARKANSAS BLUE CROSS BLUE SHIELD
AR
Enumeration date
03/20/2006
Last updated
12/02/2025
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