Ayodele Adeleke Olusanya, MD | |
120 Davy Crockett Mall, Trenton, TN 38382-2934 | |
(731) 855-2803 | |
(731) 855-1746 |
Full Name | Ayodele Adeleke Olusanya |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 21 Years |
Location | 120 Davy Crockett Mall, Trenton, Tennessee |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932155868 | NPI | - | NPPES |
3895683 | Medicaid | TN | |
3895684 | Medicaid | TN | |
4106219 | Other | TN | BCBS |
4109887 | Other | TN | BCBS |
4139060 | Other | TN | BCBS |
3895681 | Medicaid | TN | |
P00376124 | Other | TN | RR MEDICARE |
P00380502 | Other | TN | RAILROAD MEDICARE |
3895682 | Medicaid | TN | |
3895687 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 37856 (Tennessee) | Secondary |
207R00000X | Internal Medicine | 37856 (Tennessee) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Dyersburg Regional Medical Center | Dyersburg, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Cogent Healthcare Of Tennessee, Pc | 8628221165 | 56 |
Entity Name | Southeastern Physician Services Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083835441 PECOS PAC ID: 0042307852 Enrollment ID: O20071025000571 |
Entity Name | Cogent Healthcare Of Tennessee, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952654246 PECOS PAC ID: 8628221165 Enrollment ID: O20130110000564 |
Entity Name | Hospitalist Medicine Physicians Of Tennessee-tcg, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740768233 PECOS PAC ID: 3072911452 Enrollment ID: O20211015001276 |
Entity Name | Hospitalist Medicine Physicians Of Texas-tcg Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902384464 PECOS PAC ID: 3678825312 Enrollment ID: O20220127001398 |
Mailing Address | Practice Location Address |
---|---|
Ayodele Adeleke Olusanya, MD 42 Willow Green Dr, Jackson, TN 38305-9756 Ph: () - | Ayodele Adeleke Olusanya, MD 120 Davy Crockett Mall, Trenton, TN 38382-2934 Ph: (731) 855-2803 |
William C Desouza, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 120 Davy Crockett Mall, Trenton, TN 38382 Phone: 731-855-2803 Fax: 731-855-1746 |