Basic Information
Provider Information
NPI: 1164984993
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NJOKI
FirstName: CAROL
MiddleName: LILLIAN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2825 PARKLAWN DR
Address2:  
City: MIDWEST CITY
State: OK
PostalCode: 731104201
CountryCode: US
TelephoneNumber: 4056104411
FaxNumber:  
Practice Location
Address1: 2825 PARKLAWN DR
Address2:  
City: MIDWEST CITY
State: OK
PostalCode: 731104201
CountryCode: US
TelephoneNumber: 4056104411
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/01/2019
LastUpdateDate: 09/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X ARN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X39515OKY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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