Provider Demographics
NPI:1043834732
Name:IGBOKWE, LINUS IKECHUKWU
Entity Type:Individual
Prefix:DR
First Name:LINUS
Middle Name:IKECHUKWU
Last Name:IGBOKWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 BEACON DR APT 3003
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2879
Mailing Address - Country:US
Mailing Address - Phone:504-606-9478
Mailing Address - Fax:
Practice Address - Street 1:2152 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-4005
Practice Address - Country:US
Practice Address - Phone:205-838-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program