Provider Demographics
NPI:1013975580
Name:OFORI-KWAKYE, STEPHEN KWAME (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:KWAME
Last Name:OFORI-KWAKYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHEN
Other - Middle Name:KWAME
Other - Last Name:OFORI-KWAYKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3201 W GORE BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6378
Mailing Address - Country:US
Mailing Address - Phone:580-353-6000
Mailing Address - Fax:580-353-0800
Practice Address - Street 1:3201 W GORE BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6378
Practice Address - Country:US
Practice Address - Phone:580-353-6000
Practice Address - Fax:580-353-0800
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21457207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK140007439OtherRAILROAD
OK140007439OtherRAILROAD