Healthcare Provider Details

I. General information

NPI: 1265587869
Provider Name (Legal Business Name): SAINT ADEOGBA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMPREHENSIVE WELLNESS CENTER 8801 W MARKHAM STREET, SUITE 2
LITTLE ROCK AR
72205-2343
US

IV. Provider business mailing address

8801 W MARKHAM ST STE 2
LITTLE ROCK AR
72205-2343
US

V. Phone/Fax

Practice location:
  • Phone: 501-954-8800
  • Fax: 844-205-9825
Mailing address:
  • Phone: 501-954-8800
  • Fax: 501-954-8806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number39020000X
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberE-8983
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: