Provider Demographics
NPI:1831140086
Name:ESEKHEIGBE, LUKE IRABOR (OD)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:IRABOR
Last Name:ESEKHEIGBE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 SOUTHLAND WALK
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-5291
Mailing Address - Country:US
Mailing Address - Phone:770-972-2250
Mailing Address - Fax:770-972-0678
Practice Address - Street 1:3435 CENTERVILLE HWY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6117
Practice Address - Country:US
Practice Address - Phone:770-972-2250
Practice Address - Fax:770-972-0678
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002117152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist