Provider Demographics
NPI:1861506453
Name:OZOIGBO, VALENTINE CHUKS (MD)
Entity Type:Individual
Prefix:
First Name:VALENTINE
Middle Name:CHUKS
Last Name:OZOIGBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S WHITE STATION RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-7220
Mailing Address - Country:US
Mailing Address - Phone:901-767-3871
Mailing Address - Fax:901-405-9560
Practice Address - Street 1:1620 S WHITE STATION RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-7220
Practice Address - Country:US
Practice Address - Phone:901-767-3871
Practice Address - Fax:901-405-9560
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40284207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI42727Medicare UPIN