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General NPI Number Information
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NPI Number | 1609189463
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Entity Type | Individual
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Provider Name | MILDRED A. OPONDO M.D
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Gender | Female
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 2220 CANTERBURY DR
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City | HAYS
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State | KS
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Zip | 67601-2370
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Country | US
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Telephone | 785-623-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 188 HAMPTON WAY
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City | MACON
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State | GA
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Zip | 31220-8744
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Country | US
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Telephone | 770-605-7782
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 92357
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0450413
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License Number State | KS
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