Provider Demographics
NPI:1851328132
Name:OKEKE, CONSTANCE O (MD)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:O
Last Name:OKEKE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:241 CORPORATE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4975
Mailing Address - Country:US
Mailing Address - Phone:757-622-2200
Mailing Address - Fax:757-965-9493
Practice Address - Street 1:241 CORPORATE BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4975
Practice Address - Country:US
Practice Address - Phone:757-622-2200
Practice Address - Fax:757-965-9493
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101245617207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA100474409OtherOPTIMA
VA1851321832Medicaid
VA1851328132OtherVIRGINIA PREMIER
VA1851328132OtherTRICARE/TRICARE FOR LIFE
VAP00731106OtherRR MEDICARE
VA1851328132OtherTRICARE/TRICARE FOR LIFE
T13457Medicare UPIN