Provider Demographics
NPI:1477531549
Name:OKAFOR, JOACHIN U (MD)
Entity type:Individual
Prefix:DR
First Name:JOACHIN
Middle Name:U
Last Name:OKAFOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4827 E ESTEVAN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-6194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4827 E ESTEVAN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-6194
Practice Address - Country:US
Practice Address - Phone:999-999-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36747207P00000X
IN01047791207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104874697Medicaid
IN200272050Medicaid
IN000000184345OtherANTHEM
000000008958OtherMPLAN
OH2516638Medicaid
000000008958OtherMPLAN
ING43327Medicare UPIN
930099764Medicare ID - Type UnspecifiedRR MEDICARE