1801688700 NPI number — MR. MFONIDO ENO EKONG MD

Table of content: MR. MFONIDO ENO EKONG MD (NPI 1801688700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801688700 NPI number — MR. MFONIDO ENO EKONG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EKONG
Provider First Name:
MFONIDO
Provider Middle Name:
ENO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801688700
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7301 ROGERS AVENUE, MERCY HOSPITAL C FORT SMITH
Provider Second Line Business Mailing Address:
GME DEPARTMENT
Provider Business Mailing Address City Name:
FORT SMITH
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-314-1153
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7301 ROGERS AVENUE, MERCY HOSPITAL C FORT SMITH
Provider Second Line Business Practice Location Address:
GME DEPARTMENT
Provider Business Practice Location Address City Name:
FORT SMITH
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-314-1153
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)