Provider Demographics
NPI:1740295559
Name:OGLESBY, TERESA JEAN (MD)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:JEAN
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE A101
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6767
Mailing Address - Country:US
Mailing Address - Phone:251-633-8880
Mailing Address - Fax:251-378-6222
Practice Address - Street 1:75 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3271
Practice Address - Country:US
Practice Address - Phone:251-660-5787
Practice Address - Fax:251-460-7923
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2021-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00009760207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000092997Medicaid
000092997Medicare ID - Type Unspecified
AL000092997Medicaid