Individual
DR. OLUSEGUN ADESANYA ODUKOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
33693 VINE ST, WILLOWICK, OH 44095-3455
(440) 768-2794
(888) 355-7033
Mailing address
102 WOODMONT BLVD STE 600, NASHVILLE, TN 37205-5250
(888) 987-1151
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
35.120134
OH
207QA0505X
Adult Medicine Physician
4301093350
MI
207QA0505X
Adult Medicine Physician
TP891
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000637130
ANTHEM BCBS
KY
01
—
000000637135
ANTHEM BCBS
KY
05
—
3009952
—
OH
05
—
7100104620
—
KY
01
—
P00773148
RR MEDICARE
KY
Enumeration date
08/30/2008
Last updated
02/02/2026
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