Healthcare Provider Details

I. General information

NPI: 1134122237
Provider Name (Legal Business Name): FRANCIS N OGBOLU D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9163 N COUNTY ROAD 25A
PIQUA OH
45356-4524
US

IV. Provider business mailing address

PO BOX 537
SIDNEY OH
45365-0537
US

V. Phone/Fax

Practice location:
  • Phone: 937-381-9600
  • Fax:
Mailing address:
  • Phone: 937-710-4510
  • Fax: 937-710-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number34-009725
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number02713
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: