| Doctor Name: | DR. ROBERT B OGESEN |
| NPI Number: | 1164699328 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 20679 |
| Business Practice Address: | 3050 N Navajo Dr. #106 & 107 Prescott Valley, AZ - 86314 |
| Business Phone Number: | 9287757088 |
| Business Fax Number: | 9287757099 |
| Mailing Address: | 3450 N 3rd St, PHOENIX |
| State: | AZ |
| Postal Code: | 85012 |
| Phone Number: | 6022579339 |
| Fax Number: | 6022658559 |
| NPI Enumeration Date: | 05/15/2008 |
| NPI Last Update Date: | 09/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | 20679 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |