Individual
DR. EDWARD TIMOTHY OKELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1011 SOUTH WILLIAM, ATLANTA, TX 75551-3245
(903) 796-2868
(903) 796-0826
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G3658
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010017871
MEDICARE RR
—
01
—
118097
CHIPS
—
05
—
133940003
—
TX
01
—
806058
BCBS
TX
01
—
97279
BCBS
TX
01
—
A007
CHAMPUS
—
Enumeration date
07/31/2006
Last updated
08/28/2023
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