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General NPI Number Information
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NPI Number | 1104387760
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Entity Type | Individual
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Provider Name | KEIDE KERRICK AKINOLA MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 5354 REYNOLDS ST STE 202
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City | SAVANNAH
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State | GA
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Zip | 31405-6009
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Country | US
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Telephone | 912-352-0920
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Fax | 912-826-2853
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Provider Business Mailing Address
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Address Line | 5354 REYNOLDS ST STE 202
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City | SAVANNAH
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State | GA
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Zip | 31405-6009
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Country | US
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Telephone | 912-352-0920
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Fax | 912-826-2853
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 105448
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD.49573
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License Number State | AL
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