Individual
FIDELIS AJOBOME OKOTIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2555 JIMMY JOHNSON BOULEVARD, PORT ARTHUR, TX 77640-2007
(409) 853-5086
(409) 853-5084
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2015-00495
NC
207R00000X
Internal Medicine Physician
38814
SC
207R00000X
Internal Medicine Physician
70415
WI
207R00000X
Internal Medicine Physician
MD.207776
LA
207R00000X
Internal Medicine Physician
N8962
TX
208M00000X
Hospitalist Physician
0434428
KS
208M00000X
Hospitalist Physician
2015-00495
NC
208M00000X
Hospitalist Physician
MD.207776
LA
208M00000X
Hospitalist Physician
Primary
N8962
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100136014
—
WI
Enumeration date
07/22/2010
Last updated
01/30/2026
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