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DR. ENO N IKOKU M.D.
>> Military Health Care Provider >> Other Service ProvidersRegistrant NPI Number: 1376744946
Individual Registrant:DR. ENO N IKOKU M.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1500 HOOD AVENUE BUILDING 720 FORT GILLEM, GA 30297-5000 US
Tel: 404-469-3090 Fax: --
Tel: 404-469-3090 Fax: --
Contact information for business:
7256 IVERSON TRL LITHONIA, GA 30058-9019 US
Tel: 770-482-7636 Fax: --
Tel: 770-482-7636 Fax: --
Registration Information:
NPI: 1376744946
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171000000X | Other Service Providers Military Health Care Provider | GA | 30942 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
