Individual
OLUSEGUN V ATEGBOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(731) 287-2244
(731) 287-0649
Mailing address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(731) 287-2244
(731) 287-2288
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37871
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3325989
—
TN
Enumeration date
05/08/2006
Last updated
07/08/2007
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