Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 000930 | GA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 063090 | GA |
NPI | 1902083629 |
---|---|
Provider Name | Dr. John Louis-Ugbo SR. |
First Address | Atlanta, GA 30345-3805 |
Second Address | Atlanta, GA 30303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2008 |
Last Update Date | 24/05/2010 |