Individual
DR. DELE OGUNYEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 393-1912
(270) 393-1913
Mailing address
825 2ND AVE, SUITE C6, BOWLING GREEN, KY 42101-1786
(270) 393-1912
(270) 393-1913
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02920
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
02920
KY
208VP0000X
Pain Medicine Physician
02920
KY
208VP0014X
Interventional Pain Medicine Physician
02920
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000370413
BLUE CROSS
KY
05
—
64109671
—
KY
Enumeration date
09/29/2005
Last updated
06/25/2024
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