Dr. Olusegun Adesanya Odukoya
Family Doctor - Adult Medicine
11100 Euclid Ave
Cleveland
, Ohio 44106-1716
Dr. Olusegun Adesanya Odukoya
Family Doctor - Adult Medicine
11100 Euclid Ave
Cleveland
, Ohio 44106-1716
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Dr. Olusegun Adesanya Odukoya
- 24701 Euclid Ave 3rd Floor
- Euclid, OH
- Zip : 44117-1714
- Phone :
Second Address
- Dr. Olusegun Adesanya Odukoya
- 11100 Euclid Ave
- Cleveland, OH
- Zip : 44106-1716
- Fax : (216) 844-8974
- Phone : (216) 844-3944
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What is Dr. Olusegun Adesanya Odukoya ’s gender?
Is Dr. Olusegun Adesanya Odukoya a sole practitioner?
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Does Dr. Olusegun Adesanya Odukoya offers telemedicine?
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Does Dr. Olusegun Adesanya Odukoya have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 35.120134 | OH |
| N | 207QA0505X | Family Doctor - Adult Medicine | 4301093350 | MI |
| N | 207QA0505X | Family Doctor - Adult Medicine | TP891 | KY |
National Provider Identifier
| NPI | 1235387416 |
|---|---|
| Provider Name | Dr. Olusegun Adesanya Odukoya |
| First Address | Euclid, OH 44117-1714 |
| Second Address | Cleveland, OH 44106-1716 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/08/2008 |
| Last Update Date | 17/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000637130 | ANTHEM BCBS (01) | KY |
| 000000637135 | ANTHEM BCBS (01) | KY |
| 3009952 | (05) | OH |
| 7100104620 | (05) | KY |
| P00773148 | RR MEDICARE (01) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.