Provider Demographics
NPI:1295223543
Name:ATAGA, ONOMEASIKE
Entity Type:Individual
Prefix:
First Name:ONOMEASIKE
Middle Name:
Last Name:ATAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF TENNESSEE 920 MADISON AVENUE FLOOR 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-0001
Mailing Address - Country:US
Mailing Address - Phone:901-448-2400
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF TENNESSEE 920 MADISON AVENUE FLOOR 2
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-448-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000666242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry