Individual
OMOBONIKE OLOWOSUKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
2614 JEFFERSON HWY, NEW ORLEANS, LA 70121-3828
(504) 291-5100
(504) 291-5125
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
05-46887
KS
208100000X
Physical Medicine & Rehabilitation Physician
2968
TN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
334189
LA
208100000X
Physical Medicine & Rehabilitation Physician
H0083162
MD
208100000X
Physical Medicine & Rehabilitation Physician
MED-PHYS-COM-LIC-123
MT
Other
Enumeration date
11/29/2011
Last updated
02/23/2024
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