Provider Demographics
NPI:1285194431
Name:OGBU, IKECHUKWU RONALD (MD)
Entity Type:Individual
Prefix:
First Name:IKECHUKWU
Middle Name:RONALD
Last Name:OGBU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1631 11TH STREET
Mailing Address - Street 2:UNIT B
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-0436
Mailing Address - Country:US
Mailing Address - Phone:940-263-3000
Mailing Address - Fax:940-263-3018
Practice Address - Street 1:1631 11TH STREET
Practice Address - Street 2:UNIT B
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-0436
Practice Address - Country:US
Practice Address - Phone:940-263-3000
Practice Address - Fax:940-263-3018
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT6005207R00000X
NV21794207R00000X
NVLL3274207R00000X
FLME155781207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine