Rotimi A Iluyomade, MD | |
6922 Little River Tpke Ste D, Annandale, VA 22003-3285 | |
(703) 705-9306 | |
(703) 890-3114 |
Full Name | Rotimi A Iluyomade |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 6922 Little River Tpke Ste D, Annandale, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043298615 | NPI | - | NPPES |
000000521582 | Other | KY | BCBS |
64013972 | Medicaid | KY | |
000000805251 | Other | KY | BCBS- BAPTIST HEALTH MADISONVILLE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 0101221294 (Virginia) | Secondary |
207P00000X | Emergency Medicine | D0042228 (Maryland) | Primary |
Entity Name | Southern Medical Partners, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538109962 PECOS PAC ID: 8123923679 Enrollment ID: O20031206000036 |
Entity Name | Harrison Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386783868 PECOS PAC ID: 8628961018 Enrollment ID: O20040209000207 |
Entity Name | Williamson Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740492644 PECOS PAC ID: 5294828562 Enrollment ID: O20070831000176 |
Entity Name | Middlesborough Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972715878 PECOS PAC ID: 9335232321 Enrollment ID: O20070907000084 |
Entity Name | Hyden Emergency Physicians, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497036776 PECOS PAC ID: 6103099163 Enrollment ID: O20111108000187 |
Entity Name | Concord Company Of Tennessee Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649743667 PECOS PAC ID: 0345588109 Enrollment ID: O20190221000097 |
Entity Name | Western Healthcare Services Kentucky Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770243842 PECOS PAC ID: 0941695936 Enrollment ID: O20220309001033 |
Mailing Address | Practice Location Address |
---|---|
Rotimi A Iluyomade, MD 900 Hospital Dr, Madisonville, KY 42431-1644 Ph: (270) 825-5100 | Rotimi A Iluyomade, MD 6922 Little River Tpke Ste D, Annandale, VA 22003-3285 Ph: (703) 705-9306 |