Provider Demographics
NPI:1295919991
Name:OKOGBAA, CAROLA B (MD)
Entity type:Individual
Prefix:
First Name:CAROLA
Middle Name:B
Last Name:OKOGBAA
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 1:7855 HOWELL BLVD
Mailing Address - Street 2:SUITE 130A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-5256
Mailing Address - Country:US
Mailing Address - Phone:225-356-2655
Mailing Address - Fax:225-356-2358
Practice Address - Street 1:7855 HOWELL BLVD
Practice Address - Street 2:SUITE 130A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-5256
Practice Address - Country:US
Practice Address - Phone:225-356-2655
Practice Address - Fax:225-356-2358
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201426207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology