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General NPI Number Information
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NPI Number | 1588241269
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Entity Type | Individual
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Provider Name | JESSICA NDIDI UDEOGU MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2021
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 4200 EAST WASHINGTON AVE
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114
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Country | US
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Telephone | 501-534-1300
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Fax | 501-613-0848
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Provider Business Mailing Address
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Address Line | 11001 EXECUTIVE CENTER DR STE 200
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City | LITTLE ROCK
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State | AR
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Zip | 72211-4393
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Country | US
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Telephone | 501-534-1300
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Fax | 501-613-0848
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-17126
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License Number State | AR
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