Basic Information
| Provider Information | |||||||||
| NPI: | 1497040299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OGU | ||||||||
| FirstName: | UGOCHI | ||||||||
| MiddleName: | OLIVIA | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 877 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381032807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015456286 | ||||||||
| FaxNumber: | 9015458122 | ||||||||
| Practice Location | |||||||||
| Address1: | 880 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381033409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015458535 | ||||||||
| FaxNumber: | 9015456454 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2011 | ||||||||
| LastUpdateDate: | 03/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | R-9310 | IA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0207X | 280558 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology | 207RH0003X | 59537 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.