Provider Demographics
NPI:1750347183
Name:NWOGU, JOHN I (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:I
Last Name:NWOGU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-1380
Mailing Address - Country:US
Mailing Address - Phone:256-235-5860
Mailing Address - Fax:256-235-5190
Practice Address - Street 1:901 LEIGHTON AVE STE 702
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5765
Practice Address - Country:US
Practice Address - Phone:256-231-2577
Practice Address - Fax:256-231-2576
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL25365207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL263125Medicaid
AL51519304OtherBLUE CROSS BLUE SHIELD OF ALABAMA / OXFORD OFFICE
AL51013275OtherBLUE CROSS BLUE SHIELD OF ALABAMA / STRINGFELLOW HOSP
AL512-54187OtherBLUE CROSS
AL51013248OtherBLUE CROSS BLUE SHIELD OF ALABAMA / NEARMC HOSP
AL51517324OtherBLUE CROSS BLUE SHIELD OF ALABAMA / ANNISTON OFFICE
AL51013275OtherBLUE CROSS BLUE SHIELD OF ALABAMA / STRINGFELLOW HOSP
AL51519304OtherBLUE CROSS BLUE SHIELD OF ALABAMA / OXFORD OFFICE
AL1750347183OtherTRICARE
ALH10439Medicare UPIN