Individual
MARK ROBERT OGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9310 WALDEMAR RD, INDIANAPOLIS, IN 46268-1134
(317) 879-1303
Mailing address
9310 WALDEMAR RD, INDIANAPOLIS, IN 46268-1134
(317) 897-1303
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
IN01036907A
IN
2084P0805X
Geriatric Psychiatry Physician
IN01036907A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132300
—
IN
Enumeration date
05/25/2006
Last updated
12/18/2019
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