Provider Demographics
NPI:1447629662
Name:OGAR, JOHNATHAN (PA)
Entity type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:
Last Name:OGAR
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Gender:M
Credentials:PA
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Mailing Address - Street 1:5315 ELLIOTT DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-8634
Mailing Address - Country:US
Mailing Address - Phone:734-434-4110
Mailing Address - Fax:734-528-0987
Practice Address - Street 1:5315 ELLIOTT DR
Practice Address - Street 2:SUITE 102
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8634
Practice Address - Country:US
Practice Address - Phone:734-434-4110
Practice Address - Fax:734-528-0987
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2017-10-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant