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General NPI Number Information
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NPI Number | 1508053026
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Entity Type | Organization
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Legal Business Name | NOKS CORPORATION PC
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1147B E GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2611
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Country | US
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Telephone | 636-931-4441
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Fax | 636-937-4466
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Provider Business Mailing Address
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Address Line | 1147B E GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2611
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Country | US
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Telephone | 636-931-4441
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Fax | 636-937-4466
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Authorized Official
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Title or Position | OWNER
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Name | DR. NOWOKERE I ESEMUEDE
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Credential | M.D.
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Telephone | 717-816-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State | MO
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