Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101273846 | VA |
Y | 208D00000X | General Practice Physician | 0101273846 | VA |
NPI | 1144875139 |
---|---|
Provider Name | Dr. Akinyele Lawrence Akinyoola |
First Address | Albuquerque, NM 87111-3547 |
Second Address | Albuquerque, NM 87111-3547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2019 |
Last Update Date | 24/01/2022 |