MEDICARE: OKEY JUSTIN OPARANAKU M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	44562	AZ
2	207R00000X	Internal Medicine Physician	250282	NY
3	207R00000X	Internal Medicine Physician	0101244164	VA
4	207RR0500X	Rheumatology Physician	15157	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	44562	OTHER	AZ	LICENSE

General Provider Information

NPI Number	:	1588822936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OKEY JUSTIN OPARANAKU M.D

Provider Business Mailing Address
First Line	:	5105 CAMINO AL NORTE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2373
Country	:	US
Telephone Number	:	702-750-2173
Fax Number	:	702-750-2173

Provider Business Practice Location Address
First Line	:	5105 CAMINO AL NORTE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2373
Country	:	US
Telephone Number	:	702-750-2173
Fax Number	:	702-750-2173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2008
Last Update Date	:	03/24/2015

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Directions to “ OKEY JUSTIN OPARANAKU M.D” Practice Location

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