Provider Demographics
NPI:1255383246
Name:OKAFO, TOBI A (MD)
Entity type:Individual
Prefix:
First Name:TOBI
Middle Name:A
Last Name:OKAFO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774-0749
Mailing Address - Country:US
Mailing Address - Phone:229-426-7685
Mailing Address - Fax:229-426-7627
Practice Address - Street 1:119 NORMAN DORMINY DR
Practice Address - Street 2:STE B
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-8855
Practice Address - Country:US
Practice Address - Phone:229-426-7685
Practice Address - Fax:229-426-7627
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057411207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology