Provider Demographics
NPI:1659308211
Name:OKECHUKWU, VITALIS CHUKWUDI (MD)
Entity Type:Individual
Prefix:DR
First Name:VITALIS
Middle Name:CHUKWUDI
Last Name:OKECHUKWU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 81247
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598-1247
Mailing Address - Country:US
Mailing Address - Phone:337-534-4210
Mailing Address - Fax:337-534-4230
Practice Address - Street 1:1700 KALISTE SALOOM ROAD
Practice Address - Street 2:BLDG 6, STE 600
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7050
Practice Address - Country:US
Practice Address - Phone:337-534-4210
Practice Address - Fax:337-534-4230
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-02-17
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Provider Licenses
StateLicense IDTaxonomies
LA15601R207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease