DR. KENYA SEKONI ETIM M.D. NPI 1124061817

NPI Information

  • NPI: 1124061817
  • Provider Name: DR. KENYA SEKONI ETIM, M.D.
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 203 NACOGDOCHES ST STE 280
    JACKSONVILLE, TX
    ZIP 75766
  • Phone: (903) 541-5396

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NPI Details

DR. Kenya Sekoni Etim, M.D. is an adult medicine family medicine in Jacksonville, TX with 26 years of experience. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. DR. Kenya Sekoni Etim, M.D. NPI is 1124061817. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduation Year:2000

The provider's business location address is:

203 NACOGDOCHES ST STE 280
JACKSONVILLE, TX
ZIP 75766-444
Phone: (903) 541-5396

The NPI 1124061817 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 6/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0505XFamily MedicineAdult MedicineT0200TEXASYes
2207QA0505XFamily MedicineAdult Medicine4301076863MICHIGANNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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