Individual
DR. OLUKAYODE ADEOLA BAMGBELU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-4644
(601) 200-4645
Mailing address
382 SUMMERVILLE DR, MADISON, MS 39110-6926
(303) 847-2970
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20917
MS
207R00000X
Internal Medicine Physician
42781
KY
207R00000X
Internal Medicine Physician
45284
TN
207R00000X
Internal Medicine Physician
Primary
ME145551
FL
207R00000X
Internal Medicine Physician
Q1793
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05430527
—
MS
01
—
1B9305
MEDICARE
MS
Enumeration date
11/23/2008
Last updated
08/12/2020
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