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NPI Code Detail

MEDICARE: DR. PHILIP DUNN ELANGWE M.D.

MEDICARE:  DR. PHILIP DUNN ELANGWE  M.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine PhysicianE5047AR

Other Identifiers

General Provider Information

NPI Number : 1780776435
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP DUNN ELANGWE M.D.
Provider Business Mailing Address
First Line : 2420 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-4164
Country : US
Telephone Number : 479-782-0244
Fax Number : 479-709-7053
Provider Business Practice Location Address
First Line : 2420 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-4164
Country : US
Telephone Number : 479-782-0244
Fax Number : 479-782-0267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 08/05/2021

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Directions to “ DR. PHILIP DUNN ELANGWE M.D.” Practice Location

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