Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 21457 | OK |
NPI | 1013975580 |
---|---|
Provider Name | Dr. Stephen Kwame Ofori-Kwakye |
First Address | Lawton, OK 73505-6378 |
Second Address | Lawton, OK 73505-6378 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 07/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
140007439 | RAILROAD (01) | OK |
D88182 | (02) |