Provider Demographics
NPI:1740366400
Name:OKEAKPU, DONALD O (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:O
Last Name:OKEAKPU
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 1:6600 SUGARLOAF PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4452
Mailing Address - Country:US
Mailing Address - Phone:321-507-5803
Mailing Address - Fax:
Practice Address - Street 1:4401 RIVERCHASE DR
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-7483
Practice Address - Country:US
Practice Address - Phone:334-732-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2025-09-09
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-04-02
Provider Licenses
StateLicense IDTaxonomies
ALMD30981207RE0101X, 207P00000X
VA0101056685207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1740366400Medicaid
VA022734C98Medicare PIN