Organization
PRINTERS PARK OBGYN, A PROFESSIONAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN M OGDEN CMM (CERTIFIED MEDICAL MANAGER)
(719) 634-1532
Entity
Organization
Contact information
Practice address
175 S UNION BLVD, SUITE 220, COLORADO SPRINGS, CO 80910-3147
(719) 634-1532
(719) 634-1715
Mailing address
175 S UNION BLVD, SUITE 220, COLORADO SPRINGS, CO 80910-3147
(719) 634-1532
(719) 634-1715
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04018677
—
CO
01
—
PRU3708
GROUP ANTHEM BCBS NUMBER
CO
Enumeration date
06/22/2006
Last updated
09/21/2010
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