Provider Demographics
NPI:1043523913
Name:OGLE, CHRIS JON (PA)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:JON
Last Name:OGLE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39720 229TH ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:SD
Mailing Address - Zip Code:57385-6604
Mailing Address - Country:US
Mailing Address - Phone:605-770-7879
Mailing Address - Fax:
Practice Address - Street 1:1300 OAK STREET
Practice Address - Street 2:
Practice Address - City:FAULKTON
Practice Address - State:SD
Practice Address - Zip Code:57438
Practice Address - Country:US
Practice Address - Phone:605-598-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical