Healthcare Provider Details

I. General information

NPI: 1619654258
Provider Name (Legal Business Name): FRANCIS FENSI OFORI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SKYLINE DR # C307
JACKSON TN
38301-3923
US

IV. Provider business mailing address

100 CORINTHIAN CV APT C307
JACKSON TN
38305-3257
US

V. Phone/Fax

Practice location:
  • Phone: 731-541-5492
  • Fax:
Mailing address:
  • Phone: 731-313-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number76503
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number76503
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: