Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 13814R | LA |
Y | 2084N0400X | Neurologist | 13814R | LA |
NPI | 1144210717 |
---|---|
Provider Name | Charles C. Ugokwe |
First Address | Alexandria, LA 71315-2911 |
Second Address | Alexandria, LA 71301-3631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 05/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H29247 | (02) | LA |