Provider Demographics
NPI:1588043350
Name:OWOJUYIGBE, HEZEKIAH GEORGE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:HEZEKIAH
Middle Name:GEORGE
Last Name:OWOJUYIGBE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:
Other - Last Name:OWO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-328-8371
Mailing Address - Fax:386-325-1086
Practice Address - Street 1:1302 RIVER ST
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-5042
Practice Address - Country:US
Practice Address - Phone:386-328-8371
Practice Address - Fax:386-325-1086
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13606I208D00000X
PR19,119208D00000X
FLACN 746208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice