Basic Information
| Provider Information | |||||||||
| NPI: | 1396116950 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PATIENCE C ONUOHA DO PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4319 S NATIONAL AVE # 302 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658102607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024533799 | ||||||||
| FaxNumber: | 7024535741 | ||||||||
| Practice Location | |||||||||
| Address1: | 532 1ST ST NW | ||||||||
| Address2: | |||||||||
| City: | BRITT | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504231227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024533799 | ||||||||
| FaxNumber: | 7024535741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2015 | ||||||||
| LastUpdateDate: | 10/08/2015 | ||||||||
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| AuthorizedOfficialLastName: | ONUOHA | ||||||||
| AuthorizedOfficialFirstName: | PATIENCE | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9737891443 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DO-04674 | IA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | DO-04674 | 01 | IA | MEDICAL LICENSE | OTHER |