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NPI Code Detail

MEDICARE: JAMESON OBIDINMA IHUEFO

MEDICARE: JAMESON OBIDINMA IHUEFO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPD15231AR

General Provider Information

NPI Number : 1043815558
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMESON OBIDINMA IHUEFO
Provider Business Mailing Address
First Line : 525 MEADOW LN APT 235
Second Line :
City : EL DORADO
State : AR
Zip : 71730-1903
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2730 N WEST AVE
Second Line :
City : EL DORADO
State : AR
Zip : 71730-3124
Country : US
Telephone Number : 870-862-2128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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Directions to “ JAMESON OBIDINMA IHUEFO ” Practice Location

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