Healthcare Provider Details

I. General information

NPI: 1659508240
Provider Name (Legal Business Name): OBIAJULU C. OKAFOR, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 PRESIDENT PLACE SUITE 100
SMYRNA TN
37167
US

IV. Provider business mailing address

739 PRESIDENT PLACE SUITE 100
SMYRNA TN
37167
US

V. Phone/Fax

Practice location:
  • Phone: 615-355-4720
  • Fax: 615-355-4721
Mailing address:
  • Phone: 615-355-4720
  • Fax: 615-355-4721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number38118
License Number StateTN

VIII. Authorized Official

Name: OBIAJULU C OKAFOR
Title or Position: PHYSIAN
Credential: MD
Phone: 615-355-4720