Oge G Chukwu, M.D.
Individual provider Active NPI Emergency Medicine Physician · Jonesboro, GA
NPI 1528033859 · NPPES record last updated Apr 29, 2009
Key facts
- NPI
- 1528033859
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 060569 (GA)
- Practice address
- 2400 Mt. Zion Parkway
Southwood Medical Office Dept. of After Hours
Jonesboro, GA 30236 - Phone
- (770) 603-3704
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040907001179 | MO | Practitioner - General Surgery |
8325014780 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General John J Pershing Memorial Hospital Association | Current |
Accepting new patients | |
| General John J Pershing Memorial Hospital Association | Current |
Accepting new patients | |
| Apogee Medical Group, Arkansas, PA | Past | Accepting new patients | |
| Poplar Bluff Hma Physician Management, LLC | Past | Accepting new patients | |
| Apogee Medical Group Missouri Inc | Past | Accepting new patients |
Locations
130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050
101 E Hayward St
Meadville, MO 64659
Phone (660) 938-4213
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 110098 | MO | |
| Emergency Medicine Physician | 207P00000X | 060569 | GA | Yes |
Addresses
Primary practice location
2400 Mt. Zion Parkway
Southwood Medical Office Dept. of After Hours
Jonesboro, GA 30236
Mailing address
3495 Piedmont Road, NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 364-0080
Other providers in Jonesboro, GA
- Michael A Chita
- Hyunwoo Choi
- Choices Behavioral Health, LLC
- Chosen Hands Home Care Services LLC
- Christian Centered Empowerment, Inc.
- Vince Ifeanyi Chukwukelu
- Eun Chung
- Citizens Transportation 2 LLC
- Civilian Barber Surgeons
- Corion Atae Clark-Wright
All providers in Jonesboro, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.