Provider Demographics
NPI:1588822936
Name:OPARANAKU, OKEY JUSTIN (MD)
Entity type:Individual
Prefix:
First Name:OKEY
Middle Name:JUSTIN
Last Name:OPARANAKU
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 1:5105 CAMINO AL NORTE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2373
Mailing Address - Country:US
Mailing Address - Phone:702-750-2173
Mailing Address - Fax:702-750-2173
Practice Address - Street 1:5105 CAMINO AL NORTE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2373
Practice Address - Country:US
Practice Address - Phone:702-750-2173
Practice Address - Fax:702-750-2173
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44562207RR0500X
NY250282207R00000X
VA0101244164207R00000X
NV15157207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1588822936Medicaid
AZ44562OtherLICENSE
NV1588822936Medicaid