Individual
CHINENYE OGOMA IWUCHUKWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2005
Mailing address
504 CLINTON CENTER DRIVE, CBO - SUITE 4300, CLINTON, MS 39056
(601) 815-2005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01092168A
IN
208600000X
Surgery Physician
Primary
25974
MS
2086S0102X
Surgical Critical Care Physician
01092168A
IN
2086S0102X
Surgical Critical Care Physician
25974
MS
2086S0102X
Surgical Critical Care Physician
MC-2842
ID
2086S0127X
Trauma Surgery Physician
25974
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
04/01/2010
Last updated
08/02/2024
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