Basic Information
| Provider Information | |||||||||
| NPI: | 1861879926 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ONIGBINDE | ||||||||
| FirstName: | EZEKIEL | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16207 E 48TH ST | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741347291 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484955278 | ||||||||
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| Practice Location | |||||||||
| Address1: | 309 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712017407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3189664541 | ||||||||
| FaxNumber: | 3189664543 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2015 | ||||||||
| LastUpdateDate: | 11/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 31483 | OK | N | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 311060 | LA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.