Individual
OLUDAYO OLUSANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6378
(580) 220-6772
Mailing address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6378
(580) 220-6772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11018779A
IN
207Q00000X
Family Medicine Physician
Primary
40700
OK
207Q00000X
Family Medicine Physician
76604
WI
Other
Enumeration date
05/27/2016
Last updated
05/05/2023
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