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General NPI Number Information
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NPI Number | 1679495428
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Entity Type | Individual
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Provider Name | IKENNA EBERE OGBONNA MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2026
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Last Update Date | 07/25/2026
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Provider Practice Location Address
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Address Line | 1 HOSPITAL DR
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City | COLUMBIA
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State | MO
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Zip | 65201-5276
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Country | US
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Telephone | 573-277-9230
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 PRIMROSE DR APT 6C
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City | COLUMBIA
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State | MO
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Zip | 65202-1207
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Country | US
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Telephone | 573-277-9230
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 2026011320
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License Number State | MO
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