Basic Information
| Provider Information | |||||||||
| NPI: | 1124552336 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATAKPO | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | SYLVESTER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 926 SW 107TH ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731705244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057359788 | ||||||||
| FaxNumber: | 4057359882 | ||||||||
| Practice Location | |||||||||
| Address1: | 3960 WEST TECUMSEH ROAD | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052173886 | ||||||||
| FaxNumber: | 4052173418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2017 | ||||||||
| LastUpdateDate: | 11/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 0116031529 | VA | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | 7206 | OK | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.