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Individual

OLUWATOYIN FUNMILAYO OLATINWO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
203733
LA
207R00000X
Internal Medicine Physician
28393
AL
208M00000X
Hospitalist Physician
Primary
MD203733
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009912922
AL
05
009913282
AL
05
04926757
MS
01
51545237
BCBS - FILLINGIM ST
AL
01
51545253
BCBS-STANTON RD
AL
Enumeration date
05/30/2006
Last updated
12/02/2025
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