Active NPI
Dolores Ngozi Ifezue, M.D.
- Pediatrics Physician
- Lawton, OK
National Provider Identifier
1649348558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01061272A
- Practice address
- Lawton Indian Hospital
1515 Lawrie Tatum Rd
Lawton, OK 73507-3099 - Phone
- (580) 353-0350
- Fax
- (580) 353-2859
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01061272A | IN | Primary |
Addresses
Primary practice location
Lawton Indian Hospital
1515 Lawrie Tatum Rd
Lawton, OK 73507-3099
Mailing address
Lawton Indian Hospital
1515 Lawrie Tatum Rd
Lawton, OK 73507-3099
Phone (580) 353-0350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01061272A | IN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649348558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LAWTON INDIAN HOSPITAL",
"address_2": "1515 LAWRIE TATUM RD",
"city": "LAWTON",
"state": "OK",
"postal_code": "735073099",
"telephone_number": "580-353-0350",
"fax_number": "580-353-2859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LAWTON INDIAN HOSPITAL",
"address_2": "1515 LAWRIE TATUM RD",
"city": "LAWTON",
"state": "OK",
"postal_code": "735073099",
"telephone_number": "580-353-0350",
"fax_number": "580-353-2859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFEZUE",
"first_name": "DOLORES",
"middle_name": "NGOZI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01061272A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.