MEDICARE: KENNEDY KELECHI OKERE M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	22251	OK
2	207Q00000X	Family Medicine Physician	050331	GA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00394400	OTHER	GA	RAILROAD MEDICARE
4	P01106400	OTHER	GA	RAILROAD MEDICARE
9	P00187351	OTHER	GA	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1750347696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNEDY KELECHI OKERE M.D.

Provider Business Mailing Address
First Line	:	2 ROBERTS ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31408-3524
Country	:	US
Telephone Number	:	912-527-1000
Fax Number	:	912-527-1002

Provider Business Practice Location Address
First Line	:	2 ROBERTS ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31408-3524
Country	:	US
Telephone Number	:	912-527-1000
Fax Number	:	912-527-1002

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	02/14/2020

2 ROBERTS STREET
SAVANNAH, GA
31408-3524

Practice Phone: 912-527-1100
Practice Fax: 912-527-1153