Provider Demographics
NPI:1588241269
Name:UDEOGU, NDIDI JESSICA (MD)
Entity type:Individual
Prefix:DR
First Name:NDIDI
Middle Name:JESSICA
Last Name:UDEOGU
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-534-1300
Mailing Address - Fax:501-613-0848
Practice Address - Street 1:4200 EAST WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114
Practice Address - Country:US
Practice Address - Phone:501-534-1300
Practice Address - Fax:501-613-0848
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2024-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-17126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty