Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 082385 | GA |
N | 2086S0127X | Trauma Surgeon | M2735 | TX |
NPI | 1235199407 |
---|---|
Provider Name | Terence Sidney Okeeffe |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178020701 | (05) | TX |
I48495 | (02) |