Healthcare Provider Details

I. General information

NPI: 1801737291
Provider Name (Legal Business Name): LINDA UGOCHI ONYIRIMBA MD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

102 ROSALIE CT
CLINTON MS
39056-6053
US

V. Phone/Fax

Practice location:
  • Phone: 832-871-7170
  • Fax:
Mailing address:
  • Phone: 832-871-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number390200000X
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: