Dr Noble U Ezukanma, MD is a
Internal Medicine - Pulmonary Disease physician based in Lakeside, Texas. Dr Noble U Ezukanma is licensed to practice in Texas (license number K8745) and his current practice location is 8401 Jacksboro Hwy, Suite 218, Lakeside, Texas. He can be reached at his office (for appointments etc.) via phone at
(817) 338-0400.
NPI number for Dr Noble U Ezukanma is 1295705291 and his current mailing address is 508 S Adams St, Suite 218, Fort Worth, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1295705291.
Physician's Profile
| Full Name | Dr Noble U Ezukanma |
|---|
| Gender | Male |
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| Speciality | Internal Medicine - Pulmonary Disease |
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| Location | 8401 Jacksboro Hwy, Lakeside, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1295705291
- Provider Enumeration Date: 01/24/2006
- Last Update Date: 07/23/2012
Medical Identifiers
Medical identifiers for Dr Noble U Ezukanma such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295705291 | NPI | - | NPPES |
| 044684101 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | K8745 (Texas) | Secondary |
| 207RC0200X | Internal Medicine - Critical Care Medicine | K8745 (Texas) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | K8745 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Noble U Ezukanma is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Noble U Ezukanma, MD
508 S Adams St, Suite 218,
Fort Worth, TX 76104-2147
Ph: (817) 338-0400 | Dr Noble U Ezukanma, MD
8401 Jacksboro Hwy, Suite 218,
Lakeside, TX 76135-4351
Ph: (817) 338-0400 |
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