Provider Demographics
NPI:1831334440
Name:OGLESBY, WILLIE HAROLD III (MSPH, PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIE
Middle Name:HAROLD
Last Name:OGLESBY
Suffix:III
Gender:M
Credentials:MSPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 DEVINE ST STE 223
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29208-0001
Mailing Address - Country:US
Mailing Address - Phone:803-734-4752
Mailing Address - Fax:866-330-2654
Practice Address - Street 1:2221 DEVINE ST STE 223
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208-0001
Practice Address - Country:US
Practice Address - Phone:803-734-4752
Practice Address - Fax:866-330-2654
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other