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General NPI Number Information
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NPI Number | 1295223543
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Entity Type | Individual
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Provider Name | ONOMEASIKE ATAGA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 920 MADISON AVE STE 200
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City | MEMPHIS
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State | TN
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Zip | 38103-3434
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Country | US
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Telephone | 901-448-2400
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Fax | 901-302-2420
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Provider Business Mailing Address
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Address Line | 1068 CRESTHAVEN RD STE 300
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City | MEMPHIS
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State | TN
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Zip | 38119-0809
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Country | US
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Telephone | 901-866-8864
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 66624
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License Number State | TN
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