| Olabode Olumofin Md | |
|
1801 W 40th Ave Ste 1c Pine Bluff AR 71603-6956 | |
| (870) 535-4141 | |
| (870) 535-9180 |
| Full Name | Olabode Olumofin Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 1801 W 40th Ave Ste 1c, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Olabode Olumofin (PRESIDENT) |
| Authorized Official Contact | 8705346800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olabode Olumofin Md 1801 W 40th Ave Ste 1c Pine Bluff AR 71603-6956 Ph: (870) 535-4141 | Olabode Olumofin Md 1801 W 40th Ave Ste 1c Pine Bluff AR 71603-6956 Ph: (870) 535-4141 |
| NPI Number | 1750513982 |
|---|---|
| Provider Enumeration Date | 08/21/2009 |
| Last Update Date | 03/03/2011 |
| Medicare PECOS PAC ID | 9234265612 |
|---|---|
| Medicare Enrollment ID | O20100325000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750513982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | E-3124 (Arkansas) | Primary |
| Provider Name | Olabode Olumofin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720025513 PECOS PAC ID: 9638069727 Enrollment ID: I20040319001493 |
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