# EMMANUEL O. SOYOOLA MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Olan Comprehensive Womens Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104005297
- **Authorized official:** DR. EMMANUEL OLUSOLA SOYOOLA M.D.,PHD.,F.A.C.O.G. (PHYSICIAN/OWNER)
- **Authorized official phone:** (304) 752-6780

## Contact information

- **Practice address:** 70 HOSPITAL DR, KRUGER MEDICAL PLAZA, SUITE 200, LOGAN, WV 25601-3452
- **Practice address phone:** (304) 752-6780
- **Practice address fax:** (304) 752-6782
- **Mailing address:** PO BOX 536, LOGAN, WV 25601-0536
- **Mailing address phone:** (304) 752-6780
- **Mailing address fax:** (304) 752-6782

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 21399 | WV | Yes |

## Other

- **Enumeration date:** 10/25/2007
- **Last updated:** 10/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1811315000 | — | WV |