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General NPI Number Information
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NPI Number | 1083054571
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Entity Type | Individual
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Provider Name | CHRISTOPHER UGOCHUKWU UGORJI REX M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 127 E MAIN ST STE A
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City | PAYSON
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State | AZ
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Zip | 85541-5646
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Country | US
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Telephone | 928-951-0395
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Fax | 928-494-9319
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Provider Business Mailing Address
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Address Line | 127 E MAIN ST STE A
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City | PAYSON
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State | AZ
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Zip | 85541-5646
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Country | US
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Telephone | 928-951-0395
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Fax | 928-494-9319
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | A148673
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | 56105
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | A148673
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT204558
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 56105
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License Number State | AZ
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