Provider Demographics
NPI:1508442591
Name:OJEDA CRUZADO, AXEL JAVIER (MD)
Entity type:Individual
Prefix:
First Name:AXEL
Middle Name:JAVIER
Last Name:OJEDA CRUZADO
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 1:1310 CARLTON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-7604
Mailing Address - Country:US
Mailing Address - Phone:787-565-6944
Mailing Address - Fax:
Practice Address - Street 1:3068 COVINGTON PIKE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5001
Practice Address - Country:US
Practice Address - Phone:901-383-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program