Individual
MR. ADE LATEEF ADEDOKUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6116 OAKBEND TRL STE 112, FORT WORTH, TX 76132-3926
(817) 423-9054
(817) 423-9719
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8450
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
K5755
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K5755
TX
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
K5755
TX
208VP0000X
Pain Medicine Physician
K5755
TX
Other
Enumeration date
02/17/2006
Last updated
07/21/2022
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