Provider Demographics
NPI:1881918522
Name:OKAFOR, INEADA (MD)
Entity type:Individual
Prefix:DR
First Name:INEADA
Middle Name:
Last Name:OKAFOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:INEADA
Other - Middle Name:
Other - Last Name:JACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10001 S EASTERN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:702-433-2477
Practice Address - Street 1:871 CORONADO CENTER DR STE 141
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3977
Practice Address - Country:US
Practice Address - Phone:702-566-2400
Practice Address - Fax:702-433-2477
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14822208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
7025662400OtherEMPLOYER