Individual
USIAKIMI IGBASEIMOKUMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS, FRCS(C), MD
Contact information
Practice address
4102 24TH ST STE 504, LUBBOCK, TX 79410
(806) 743-7700
(806) 743-7703
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
FTL41604
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205463300
—
MO
01
—
782343
HEALTHLINK
MO
Enumeration date
10/25/2006
Last updated
12/03/2021
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