1134168578 NPI number — MRS. IFEOMA ROSELINE OKEKE M.D.

Table of content: MRS. IFEOMA ROSELINE OKEKE M.D. (NPI 1134168578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134168578 NPI number — MRS. IFEOMA ROSELINE OKEKE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OKEKE
Provider First Name:
IFEOMA
Provider Middle Name:
ROSELINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134168578
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2210 GREEN VALLEY ROAD
Provider Second Line Business Mailing Address:
FLOYD MEMORIAL CANCER CENTER OF INDIANA
Provider Business Mailing Address City Name:
NEW ALBANY
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-945-4000
Provider Business Mailing Address Fax Number:
812-941-5714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2210 GREEN VALLEY ROAD
Provider Second Line Business Practice Location Address:
FLOYD MEMORIAL CANCER CENTER OF INDIANA
Provider Business Practice Location Address City Name:
NEW ALBANY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-945-4000
Provider Business Practice Location Address Fax Number:
812-941-5714
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  01047487A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RH0003X , with the licence number: 35-088183 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1841239274 . This is a "PARTNERS PHYSICIAN GROUP TYPE 2 NPI #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 9338635 . This is a "PARTNERS PHYSICIAN GROUP MEDICARE GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2767457 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200437820 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2551671 . This is a "PARTNERS PHYSICIAN GROUP MEDICAID GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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