Provider Demographics
NPI:1659508240
Name:OBIAJULU C. OKAFOR, M.D.
Entity Type:Organization
Organization Name:OBIAJULU C. OKAFOR, M.D.
Other - Org Name:SMYRNA OBSTETRICS AND GYNECOLOGY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSIAN
Authorized Official - Prefix:
Authorized Official - First Name:OBIAJULU
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-355-4720
Mailing Address - Street 1:739 PRESIDENT PLACE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167
Mailing Address - Country:US
Mailing Address - Phone:615-355-4720
Mailing Address - Fax:615-355-4721
Practice Address - Street 1:739 PRESIDENT PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167
Practice Address - Country:US
Practice Address - Phone:615-355-4720
Practice Address - Fax:615-355-4721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38118207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1511380Medicaid