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General NPI Number Information
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NPI Number | 1750347183
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Entity Type | Individual
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Provider Name | JOHN I NWOGU M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 901 LEIGHTON AVE STE 702
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City | ANNISTON
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State | AL
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Zip | 36207-5765
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Country | US
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Telephone | 256-231-2577
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Fax | 256-231-2576
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Provider Business Mailing Address
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Address Line | PO BOX 1380
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City | ANNISTON
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State | AL
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Zip | 36202-1380
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Country | US
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Telephone | 256-235-5860
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Fax | 256-235-5190
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25365
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License Number State | AL
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