MEDICARE: CONSTANCE O OKEKE MD

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	207W00000X	Ophthalmology Physician	0101245617	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00731106	OTHER	VA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100474409	OTHER	VA	OPTIMA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1851328132	OTHER	VA	VIRGINIA PREMIER
4	1851328132	OTHER	VA	TRICARE/TRICARE FOR LIFE

General Provider Information

NPI Number	:	1851328132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE O OKEKE MD

Provider Business Mailing Address
First Line	:	241 CORPORATE BLVD
Second Line	:	SUITE 210
City	:	NORFOLK
State	:	VA
Zip	:	23502-4975
Country	:	US
Telephone Number	:	757-622-2200
Fax Number	:	757-965-9493

Provider Business Practice Location Address
First Line	:	241 CORPORATE BLVD
Second Line	:	SUITE 210
City	:	NORFOLK
State	:	VA
Zip	:	23502-4975
Country	:	US
Telephone Number	:	757-622-2200
Fax Number	:	757-965-9493

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	10/16/2015

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Directions to “ CONSTANCE O OKEKE MD” Practice Location

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