| Eguosa Llc | |
|
1300 Wesley Dr Memphis TN 38116-6426 | |
| (901) 516-3700 | |
| Not Available |
| Full Name | Eguosa Llc |
|---|---|
| Speciality | Internal Medicine - Medical Oncology |
| Location | 1300 Wesley Dr, Memphis, Tennessee |
| Authorized Official Name and Position | Egunmwendia Ogbeide (PRESIDENT) |
| Authorized Official Contact | 9013777308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eguosa Llc Po Box 1891 Collierville TN 38027-1891 Ph: (901) 516-3700 | Eguosa Llc 1300 Wesley Dr Memphis TN 38116-6426 Ph: (901) 516-3700 |
| NPI Number | 1407382492 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 09/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407382492 | NPI | - | NPPES |
| Q02814 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Tennessee) | Secondary |
| 207RX0202X | Internal Medicine - Medical Oncology | (* (Not Available)) | Primary |
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