Provider Demographics
NPI:1922806876
Name:OKAFOR, CHIDIEBERE KINGSLEY
Entity type:Individual
Prefix:
First Name:CHIDIEBERE
Middle Name:KINGSLEY
Last Name:OKAFOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4914 JOCKS LN
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1753
Mailing Address - Country:US
Mailing Address - Phone:404-951-9148
Mailing Address - Fax:
Practice Address - Street 1:4914 JOCKS LN
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1753
Practice Address - Country:US
Practice Address - Phone:404-951-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHCP013165251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health