Healthcare Provider Details

I. General information

NPI: 1215497466
Provider Name (Legal Business Name): MOROLAKE UGHEGHE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2019
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13041 N DEL WEBB BLVD
SUN CITY AZ
85351-3034
US

IV. Provider business mailing address

4629 N 181ST DR
GOODYEAR AZ
85395-5416
US

V. Phone/Fax

Practice location:
  • Phone: 623-832-0300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number010667
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: