Provider Demographics
NPI:1568663870
Name:ORJI, CLARA CHINYERE
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:CHINYERE
Last Name:ORJI
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 1:4519 WOODRUFF ROAD
Mailing Address - Street 2:SUITE 4 PMB 349
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6011
Mailing Address - Country:US
Mailing Address - Phone:706-653-2255
Mailing Address - Fax:706-653-2329
Practice Address - Street 1:2737 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6859
Practice Address - Country:US
Practice Address - Phone:706-653-2255
Practice Address - Fax:706-653-2329
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN246152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN246152OtherGA LICENSE NUMBER
AL891017442Medicaid
AL051542443OtherBCBS
AL051544462OtherBCBS
AL051596685OtherBCBS
AL051544472OtherBCBS
AL891017428Medicaid
AL891017434Medicaid
AL891017438Medicaid
AL051559684Medicare PIN
AL051544470OtherBCBS
AL051544473OtherBCBS
AL891017441Medicaid
AL051544475OtherBCBS
AL051542441OtherBCBS
AL051542442OtherBCBS
AL051544468OtherBCBS
AL891017433Medicaid
AL891017439Medicaid
AL051544464OtherBCBS
AL891017436Medicaid
AL891017437Medicaid
AL891017463Medicaid
AL051542440OtherBCBS
AL891017462Medicaid