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Individual

DR. BANKOLE O BOTU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
289 IRELAND AVE, BLDG. 851 WTC UNIT, FORT KNOX, KY 40121-5111
(502) 624-9844
(502) 624-9578
Mailing address
289 IRELAND AVE, BLDG. 851 WTC UNIT, FORT KNOX, KY 40121-5111
(502) 624-9844
(502) 624-9578

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33272
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64034242
KY
Enumeration date
05/10/2006
Last updated
03/24/2010
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