Individual
KENECHUKWU OFORDEME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR, JACKSONVILLE, FL 32209-6511
(904) 244-3837
(904) 244-4508
Mailing address
655 W 8TH ST # C506, CLINICAL CENTER, 1ST FLOOR, JACKSONVILLE, FL 32209-6511
(904) 244-3837
(904) 244-4508
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N1404
TX
207P00000X
Emergency Medicine Physician
TRN9215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202491101
—
TX
Enumeration date
01/12/2007
Last updated
08/11/2009
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