DR. ENIOLA OLADOSU FAGBONGBE (NPI# 1912394495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912394495 |
Entity Type | Individual |
Full Name | DR. ENIOLA OLADOSU FAGBONGBE |
Credential | M.D. |
Practice Address |
1265 Union Ave, 7 Thomas Wing, Room 707 Memphis TN 38104 |
Practice Telephone | 9015168675 |
Mailing Telephone | 9015168675 |
Enumeration Date | 2015-04-22 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
57.028708 | OH | Allopathic & Osteopathic Physicians |
N | 208600000X | Surgery | BP10052972 | TX | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1 Baylor Plz Ste 404d, Houston, TX 770303411 | 7137988629 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790737807 | Eniola O Fagbongbe | Obstetrics & Gynecology | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-05-17 |
Street Address |
1265 UNION AVE, 7 THOMAS WING, ROOM 707 |
City | MEMPHIS |
State | TN |
Zip Code | 38104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
Find all providers in zip 38104 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003417197 | West Clinic, P. C. | Radiology | 5999 Manor Cv, Memphis, TN 38120-3105 | 2020-11-04 |
1114528205 | West Clinic, P. C. | Radiology | 708 W Suggs Dr, Memphis, TN 38120-2741 | 2020-11-04 |
1447851530 | West Clinic, P. C. | Radiology | 5740 The Forest Gate Rd, Memphis, TN 38120-2540 | 2020-11-04 |
1720689169 | West Clinic, P. C. | Radiology | 5396 Gwynne Rd, Memphis, TN 38120-1908 | 2020-11-03 |
1558990788 | Sanitas Medical Center of Tennessee PC | Radiology | 438 N Cleveland St, Memphis, TN 38104-7014 | 2020-04-08 |
1033554589 | Phillip Osborn Flinn | Radiology | 1325 Eastmoreland Ave Ste 545, Memphis, TN 38104-7510 | 2013-05-09 |
1952656316 | William Eugene Long | Radiology | 155 Trezevant View Pl, Memphis, TN 38111-4759 | 2012-07-20 |
1720377583 | Adeel Siddiqui | Radiology | 848 Adams Ave Ground Fl, Memphis, TN 38103 | 2011-04-01 |
1497055081 | Stephen Lane Gammill Sr. | Radiology | 2935 Iroquois Rd, Memphis, TN 38111-2615 | 2010-10-28 |
1659698942 | Scott Neill Osborne | Radiology | 7695 Poplar Pike Ste 101, Memphis, TN 38138-5947 | 2010-04-26 |
Find all providers in MEMPHIS |
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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.