Healthcare Provider Details

I. General information

NPI: 1811516933
Provider Name (Legal Business Name): KINSLEY ECHEZONA OJUKWU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HOSPITAL DR
LEXINGTON NC
27292-6792
US

IV. Provider business mailing address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-238-4152
  • Fax: 336-238-4150
Mailing address:
  • Phone: 336-238-4152
  • Fax: 336-238-4150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number68797
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2025-02027
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number68797
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: