Organization
ROLLA URGENT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUYOMI OLUSANYA MD (OWNER/DEL OFFICIAL)
(573) 426-5900
Entity
Organization
Contact information
Practice address
1060 S BISHOP AVE, ROLLA, MO 65401-4411
(573) 426-5900
(573) 426-4466
Mailing address
PO BOX 817, CAPE GIRARDEAU, MO 63702-0817
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2002009086
MO
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
124268
MO
Other
Enumeration date
05/13/2006
Last updated
09/14/2017
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