Provider Demographics
NPI:1407998990
Name:OKONS, TOBY B (MD)
Entity Type:Individual
Prefix:DR
First Name:TOBY
Middle Name:B
Last Name:OKONS
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 1:3758 S MAIN ST
Mailing Address - Street 2:P.O. BOX 665
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-1959
Mailing Address - Country:US
Mailing Address - Phone:910-429-0647
Mailing Address - Fax:910-429-0791
Practice Address - Street 1:3758 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1959
Practice Address - Country:US
Practice Address - Phone:910-429-0647
Practice Address - Fax:910-429-0791
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0266QOtherBCBS
NC89012WMMedicaid
NC2229609DMedicare ID - Type Unspecified
NC0266QOtherBCBS