Organization
OKOLOCHA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL OKOLOCHA MD (OWNER)
(219) 949-7540
Entity
Organization
Contact information
Practice address
2054 GRANT ST, GARY, IN 46404-3060
(219) 949-7540
(219) 949-7545
Mailing address
2054 GRANT ST, GARY, IN 46404-3060
(219) 949-7540
(219) 949-7545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004976
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201272350
—
IN
Enumeration date
07/12/2016
Last updated
07/12/2016
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