Individual
OLUGBEMI O ELEGBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 W RIVER ST, OZARK, AR 72949-3127
(479) 667-4138
(479) 667-9778
Mailing address
4900 PARK AVE, STE. 304, FORT SMITH, AR 72903-1478
(479) 478-6174
(479) 314-1194
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
Q3177
TX
207Q00000X
Family Medicine Physician
E-6310
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07833
—
LA
Enumeration date
05/23/2007
Last updated
06/12/2018
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