Provider Demographics
NPI:1699390427
Name:MATTHEW OKEKE, M.D. LTD
Entity Type:Organization
Organization Name:MATTHEW OKEKE, M.D. LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-622-6974
Mailing Address - Street 1:2021 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3137
Mailing Address - Country:US
Mailing Address - Phone:775-622-6974
Mailing Address - Fax:
Practice Address - Street 1:1721 E CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1902
Practice Address - Country:US
Practice Address - Phone:775-622-6974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MATTHEW OKEKE, M.D. LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care