DR. ODILICHI EZENWANNE M.D. NPI 1841504206

NPI Information

  • NPI: 1841504206
  • Provider Name: DR. ODILICHI EZENWANNE, M.D.
  • Classification: Preventive Medicine - 2083P0901X
  • Specialization: Public Health & General Preventive Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1820 PEABODY ST
    TUNICA, MS
    ZIP 38676
  • Phone: (662) 363-3656

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NPI Details

DR. Odilichi Ezenwanne, M.D. is a public health and general preventive medicine preventive medicine in Tunica, MS with 25 years of experience. The provider is public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. DR. Odilichi Ezenwanne, M.D. NPI is 1841504206. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1820 PEABODY ST
TUNICA, MS
ZIP 38676-441
Phone: (662) 363-3656

The NPI 1841504206 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/27/2010 and was last updated on 2/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083P0901XPreventive MedicinePublic Health & General Preventive Medicine27125MISSISSIPPINo
22083P0901XPreventive MedicinePublic Health & General Preventive Medicine67275WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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