Individual
DR. OLAWALE FASHINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
615 EASTWYCK DR, RIDGELAND, MS 39157-3620
(601) 362-4471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14518
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115381
—
MS
Enumeration date
07/14/2006
Last updated
07/08/2007
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