Individual
KEITA OKUBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
545 BARNHILL DR, INDIANAPOLIS, IN 46202-5112
(317) 278-0394
Mailing address
545 BARNHILL DR, INDIANAPOLIS, IN 46202-5112
(317) 278-0394
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
00000000
AZ
208600000X
Surgery Physician
R78314
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11022612A
IN
Other
Enumeration date
05/21/2020
Last updated
07/27/2022
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