Healthcare Provider Details

I. General information

NPI: 1841989498
Provider Name (Legal Business Name): LAURA AKUGBE IMARHIAGBE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 08/11/2025
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 S GLOSTER ST
TUPELO MS
38801
US

IV. Provider business mailing address

830 S GLOSTER ST
TUPELO MS
38801
US

V. Phone/Fax

Practice location:
  • Phone: 662-377-3000
  • Fax: 901-448-7836
Mailing address:
  • Phone: 662-377-3000
  • Fax: 901-448-7836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: