Healthcare Provider Details

I. General information

NPI: 1649275058
Provider Name (Legal Business Name): FRANK A OGNIBENE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7878 WINCHESTER RD
MEMPHIS TN
38125-2307
US

IV. Provider business mailing address

PO BOX 847
CORDOVA TN
38088-0847
US

V. Phone/Fax

Practice location:
  • Phone: 901-757-0045
  • Fax: 901-756-4413
Mailing address:
  • Phone: 901-821-0338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number80092
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM 178
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: