Provider Demographics
NPI:1518490648
Name:KAMOGA, DOREEN MPIRIRWE (MD)
Entity Type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:MPIRIRWE
Last Name:KAMOGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7303
Mailing Address - Country:US
Mailing Address - Phone:870-262-1200
Mailing Address - Fax:
Practice Address - Street 1:1710 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7303
Practice Address - Country:US
Practice Address - Phone:870-262-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-13029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine