Healthcare Provider Details

I. General information

NPI: 1326492695
Provider Name (Legal Business Name): CHIKA OKAFOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MEDICAL DR STE 707
LAGRANGE GA
30240-4130
US

IV. Provider business mailing address

300 MEDICAL DR STE 707
LAGRANGE GA
30240-4130
US

V. Phone/Fax

Practice location:
  • Phone: 706-803-7921
  • Fax:
Mailing address:
  • Phone: 706-803-7921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME156456
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number98046
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME156456
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: