Individual
DR. OLUSEUN O. MEDEYINLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
4900 HOUSTON RD, FLORENCE, KY 41042-4824
(859) 212-7700
(859) 212-7710
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 212-7700
(859) 212-7710
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
41560
KY
207RP1001X
Pulmonary Disease Physician
238066
NY
207RP1001X
Pulmonary Disease Physician
Primary
41560
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2966849
—
OH
05
—
7100062500
—
KY
01
—
P00633297
RAILROAD MEDICARE
KY
01
—
P00840872
RAILROAD MEDICARE
KY
Enumeration date
05/10/2007
Last updated
09/13/2018
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