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Organization
FAMILY FOOT AND ANKLE CLINIC
Active
Organization
FAMILY FOOT AND ANKLE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDOZIE CHUKWUDINMA OKEREKE DPM (PODIATRIST)
(318) 869-2960
Entity
Organization
Contact information
Practice address
3626 YOUREE DR, SHREVEPORT, LA 71105-2122
(318) 869-2960
(318) 869-2958
Mailing address
3626 YOUREE DR, SHREVEPORT, LA 71105-2122
(318) 869-2960
(318) 869-2958
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD196R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1999105
—
LA
Enumeration date
02/08/2010
Last updated
03/03/2010
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