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Individual

DR. IKENNA S. NZEOGU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
388 BEN BOLT AVE, TAZEWELL, VA 24651-5386
(276) 988-8740
(276) 988-5941
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04652
KY
207P00000X
Emergency Medicine Physician
3039
WV
207P00000X
Emergency Medicine Physician
Primary
DO2025-0026
NM
207Q00000X
Family Medicine Physician
0102203356
VA
207Q00000X
Family Medicine Physician
3039
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000378682
BLUECROSS BLUESHIELD
OH
01
000000527464
ANTHEM BCBS
OH
05
2048153
OH
Enumeration date
01/25/2006
Last updated
05/06/2026
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