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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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