Provider Demographics
NPI:1538220736
Name:ENT CONSULTANTS
Entity type:Organization
Organization Name:ENT CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSASERE
Authorized Official - Middle Name:LAMBERT
Authorized Official - Last Name:AGHEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:334-872-4778
Mailing Address - Street 1:731 DALLAS AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-5452
Mailing Address - Country:US
Mailing Address - Phone:334-872-4778
Mailing Address - Fax:334-872-8646
Practice Address - Street 1:731 DALLAS AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-5452
Practice Address - Country:US
Practice Address - Phone:334-872-4778
Practice Address - Fax:334-872-8646
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENT CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-12
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO-644207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009918380Medicaid
AL51039993OtherBCBS
AL040014607OtherPALMETTO RR MEDICARE
AL009918380Medicaid
AL040014607OtherPALMETTO RR MEDICARE