Provider Demographics
NPI:1790812246
Name:WEJINYA, ADESUA OKUPA (BS, MD)
Entity Type:Individual
Prefix:DR
First Name:ADESUA
Middle Name:OKUPA
Last Name:WEJINYA
Suffix:
Gender:F
Credentials:BS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S 52ND ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8605
Mailing Address - Country:US
Mailing Address - Phone:479-464-8887
Mailing Address - Fax:
Practice Address - Street 1:700 S 52ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8605
Practice Address - Country:US
Practice Address - Phone:479-464-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARIN PROGRESS207KA0200X
ARE-7110207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy