Provider Demographics
NPI:1467625145
Name:OKONGWU, FRANCELLE W (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCELLE
Middle Name:W
Last Name:OKONGWU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3073 PANTHERSVILLE RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-3828
Mailing Address - Country:US
Mailing Address - Phone:404-243-2165
Mailing Address - Fax:
Practice Address - Street 1:3073 PANTHERSVILLE RD BLDG 5
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-3828
Practice Address - Country:US
Practice Address - Phone:404-243-2165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1049852084P0804X
390200000X
GA0723792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty