Provider Demographics
NPI:1790975902
Name:OGNIBENE CLINICS
Entity Type:Organization
Organization Name:OGNIBENE CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:OGNIBENE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:901-757-0045
Mailing Address - Street 1:2120 EXETER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3964
Mailing Address - Country:US
Mailing Address - Phone:901-757-0045
Mailing Address - Fax:901-756-4413
Practice Address - Street 1:2120 EXETER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3964
Practice Address - Country:US
Practice Address - Phone:901-757-0045
Practice Address - Fax:901-756-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000179213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3350968Medicare PIN
TNT61069Medicare UPIN
TN4342610001Medicare NSC
TN406480336BMedicare PIN