FORTUNE EGBULEFU


Address: 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600
Phone: 7026533040

FORTUNE EGBULEFU (NPI# 1497002471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497002471
Entity Type Individual
Full Name FORTUNE EGBULEFU
Credential MD
Practice Address 4700 Las Vegas Blvd N
Nellis Afb
NV 89191-6600
Practice Telephone 7026533040
Mailing Telephone 7026533040
Enumeration Date 2012-08-09
Last Update Date 2020-08-20
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XS0114X Orthopaedic Surgery
Specialization: Adult Reconstructive Orthopaedic Surgery
036.148440 IL Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
12200 Warwick Blvd Ste 310, Newport News, VA 236012344 7575349988 7575345688

Office Location

Street Address 4700 LAS VEGAS BLVD N
City NELLIS AFB
State NV
Zip Code 89191-6600

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366445389 Frank J Andriola Internal Medicine 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2005-05-23
1245837392 Cameron Springer Military Health Care Provider 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-10-01
1063026474 Haley Suzanne Emery Physician Assistant 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-09-02
1033729991 Brock Shaw Dentist 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-08-05
1801404397 Madelyn Danielle Golden Military Health Care Provider 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-07-21
1114544103 Jami Myong Reece Family Medicine 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-06-25
1225654296 Leah Corr Physician Assistant 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-06-24
1821614405 Aubrey Amanda Blanchette Student in an Organized Health Care Education/Training Program 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-06-19
1346866290 Shelbi Diane Duncan Physician Assistant 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-06-17
1235751538 Howard Luong Physician Assistant 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 2020-05-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225662687 Ashley Raye Roth-garcia Student in an Organized Health Care Education/Training Program 99th Medical Group 4700 Las Vegas Blvd North, Nellis Afb, NV 89191 2020-02-25
1427553734 Christopher Robert Weisgarber Student in an Organized Health Care Education/Training Program Mike O'callaghan Military Medical Center, 4700 Las Vegas Blvd North Bldg 1300, Las Vegas, NV 89191 2018-03-28
1912345448 Austin Joseph Ladner Dentist 99th Air Base Wing Public Affairs, Fpo, AA 89191 2013-06-06
1528329018 Mayer M Jeppson Psychologist 4700 Las Vegas Blvd. N, Nellis Afb, NV 89191 2012-05-31
1255560462 Jordan Lawrence Military Health Care Provider 1579 Malmstrom Avenue, Nellis Afb, NV 89191 2009-07-09
1225263072 Adrienne L Clark Military Health Care Provider 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191 2009-05-22
1568634335 Eleanor C Basilio Registered Nurse 4700 Las Vegas Blvd., Nellis Afb, NV 89191 2008-04-01
1316137037 Sarah Rachel Glick Pediatrics 4700 N. Las Vegas Blvd., Mike O'callaghan Federal Medical Center, 99 Mdos/sgoc, Nellis Afb, NV 89191 2007-07-30
1619181302 Ben Carter Robinson Orthopaedic Surgery 4700 N. Las Vegas Blvd, Nellis Afb-mofh Nellis Orthopedics, Las Vegas, NV 89191 2007-05-10
1609992205 Conrad Lochner IIi, Odpc Optometrist 5691 Rickenbacker Road, Bldg. 431, Las Vegas, NV 89191 2007-03-22
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Taxonomy Information

Taxonomy Code 207XS0114X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Adult Reconstructive Orthopaedic Surgery

Taxonomy Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1720212673 Parminder S Kang Orthopaedic Surgery 2800 E Desert Inn Rd, #100, Las Vegas, NV 89121-3608 2009-05-06
1295840841 John J Kastrup Orthopaedic Surgery 1505 Wigwam Pkwy, #330, Henderson, NV 89074-8194 2006-08-21

Competitor

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City NELLIS AFB
Zip Code 89191

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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