Doctor Name: | ANIETIE E OKON |
NPI Number: | 1568689958 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A102633 |
Business Practice Address: | 1100 Marshall Way Marshall Medical Center Placerville, CA - 95667 |
Business Phone Number: | 5306261166 |
Business Fax Number: | 5306263826 |
Mailing Address: | 681 Main Street, Ste. 105 PLACERVILLE |
State: | CA |
Postal Code: | 95667 |
Phone Number: | 5306261166 |
Fax Number: | 5306263826 |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 11/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | A102633 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |