Provider Demographics
NPI:1891229928
Name:OKOH, ALEXIS KOFI (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:KOFI
Last Name:OKOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:K
Other - Last Name:OKOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2200 MEDICAL CENTER BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-7769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 MEDICAL CENTER BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-7769
Practice Address - Country:US
Practice Address - Phone:678-644-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA88380207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1891229928Medicaid