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NPI Code Detail

MEDICARE: DR. OSARENREN OGBEIDE MD

MEDICARE: DR. OSARENREN OGBEIDE MD
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
1207R00000XInternal Medicine PhysicianE4027AR
2207RH0003XHematology & Oncology PhysicianE-4027AR
3207RH0003XHematology & Oncology Physician23549MS
4207RH0003XHematology & Oncology Physician768803TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952375156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OSARENREN OGBEIDE MD
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 315
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 N HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2146
Country : US
Telephone Number : 901-683-0055
Fax Number : 901-322-2947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 06/01/2022

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Directions to “ DR. OSARENREN OGBEIDE MD” Practice Location

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