Individual
DR. CELESTINE JAIN-OFOMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 BELLINGER ST, EAU CLAIRE, WI 54703-5222
(715) 838-5222
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0002
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-29127
KS
207Q00000X
Family Medicine Physician
0429127
KS
207R00000X
Internal Medicine Physician
04-29127
KS
207R00000X
Internal Medicine Physician
Primary
21150
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100402730D
—
KS
05
—
100402730F
—
KS
01
—
105533
BCBS
KS
01
—
1831137249
BLUE CROSS BLUE SHIELD
KS
Enumeration date
06/04/2006
Last updated
09/20/2021
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