Individual
DR. AKINNIYI BABASOLA ODUTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
475 SUMNER AVE, SPRINGFIELD, MA 01108-2321
(413) 241-6152
(413) 241-6153
Mailing address
84 LAWRENCE DR, LONGMEADOW, MA 01106-1618
(413) 241-6152
(413) 241-6153
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210668
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049829
BMC HEALTHNET #
MA
01
—
0030525
NEIGHBORHOOD HEALTH PLAN #
MA
01
—
210668
PROVIDER CONNECTICARE #
—
05
—
2159821 / 110080500A
—
MA
01
—
2450995
UNITED HEALTHCARE #
—
01
—
32424
PROVIDER HNE #
MA
01
—
3842111
AETNA #
—
01
—
49849
PROVIDER CHILDRENS MEDICAL SECURITY PLAN #
MA
01
—
692538
TUFTS #
—
01
—
8207136
CIGNA
MA
01
—
97431403
NETWORK HEALTH
MA
01
—
J25872
BC/BS NUMBER
MA
01
—
MO0497950A
CSR NUMBER
MA
Enumeration date
04/18/2006
Last updated
03/07/2023
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