Provider Demographics
NPI:1508053026
Name:NOKS CORPORATION PC
Entity Type:Organization
Organization Name:NOKS CORPORATION PC
Other - Org Name:THE VASCULAR ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOWOKERE
Authorized Official - Middle Name:I
Authorized Official - Last Name:ESEMUEDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-816-2002
Mailing Address - Street 1:1147B E GANNON DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2611
Mailing Address - Country:US
Mailing Address - Phone:636-931-4441
Mailing Address - Fax:636-937-4466
Practice Address - Street 1:1147B E GANNON DR
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2611
Practice Address - Country:US
Practice Address - Phone:636-931-4441
Practice Address - Fax:636-937-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODC5781OtherRAILROAD MEDICARE
MO209068709Medicaid
MO000014181Medicare PIN