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General NPI Number Information
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NPI Number | 1073028536
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Entity Type | Organization
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Legal Business Name | OKEH HEALTH GROUP, LLC
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 33 UPPER RIVERDALE RD SW 17
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City | RIVERDALE
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State | GA
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Zip | 30274
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Country | US
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Telephone | 770-897-7043
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Fax | 770-996-3529
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Provider Business Mailing Address
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Address Line | 3719 CASTEEL PARK DR SW
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City | MARIETTA
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State | GA
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Zip | 30064-1692
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Country | US
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Telephone | 770-897-7043
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. VICTOR OKEH
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Credential | MD
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Telephone | 770-897-7043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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