Provider Demographics
NPI:1265674147
Name:OKEHI, OBI C (MD)
Entity Type:Individual
Prefix:DR
First Name:OBI
Middle Name:C
Last Name:OKEHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FARMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31028-6508
Mailing Address - Country:US
Mailing Address - Phone:478-971-0711
Mailing Address - Fax:404-393-9457
Practice Address - Street 1:106 FARMINGTON CT
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:GA
Practice Address - Zip Code:31028-6508
Practice Address - Country:US
Practice Address - Phone:478-971-0711
Practice Address - Fax:404-393-9457
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21567174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist