Provider Demographics
NPI:1306985395
Name:OKEE EKENNA, INC
Entity type:Organization
Organization Name:OKEE EKENNA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:EKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-769-2588
Mailing Address - Street 1:3702 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39563-6218
Mailing Address - Country:US
Mailing Address - Phone:228-769-2588
Mailing Address - Fax:228-769-2589
Practice Address - Street 1:3702 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39563-6218
Practice Address - Country:US
Practice Address - Phone:228-769-2588
Practice Address - Fax:228-769-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13816207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS009505210OtherALACAID
MS414338860BOtherAHS STATE
MS414338860BOtherBLUE CROSS
MS04178015Medicaid
MS110101525OtherMEDICARE RAILROAD
MS106036700OtherUSDOL
MS009505210OtherALACAID