Provider Demographics
NPI:1104918556
Name:OFOTOKUN, IGHOVWERHA (MD)
Entity type:Individual
Prefix:DR
First Name:IGHOVWERHA
Middle Name:
Last Name:OFOTOKUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EMORY UNIVERSITY SCHOOL OF MEDICINE, DEPT. OF MEDICINE
Mailing Address - Street 2:DIVISION OF INFECTIOUS DISEASES, 69 JESSE HILL JR. DR.
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-616-0659
Mailing Address - Fax:404-616-0592
Practice Address - Street 1:341 PONCE DE LEON AVENUE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-616-0659
Practice Address - Fax:404-616-0592
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053346207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease