Organization
BRIDGE CLINICS LLC
Active
Organization
BRIDGE CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATIFAT A. OYEKOLA MD (OWNER)
(317) 495-5173
Entity
Organization
Contact information
Practice address
6357 ROCKVILLE RD, INDIANAPOLIS, IN 46214-3920
(317) 757-2563
(317) 405-9970
Mailing address
6357 ROCKVILLE RD, INDIANAPOLIS, IN 46214-3920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
01/04/2019
Last updated
03/08/2021
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