Individual
DR. SOLOMON C MOGBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1401 KANIS PARK DR, STE 200, LITTLE ROCK, AR 72205-4571
(501) 537-4590
(501) 537-4591
Mailing address
1401 KANIS PARK DR, STE 200, LITTLE ROCK, AR 72205-4571
(501) 537-4590
(501) 537-4591
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E1875
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145707001
—
AR
01
—
912187095
TAX IDENTIFCATION
AR
Enumeration date
08/09/2005
Last updated
09/11/2020
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