Individual
ABIMBOLA A ODUKOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3741 ROME DR, SUITE B, LAFAYETTE, IN 47905-4490
(765) 607-6160
(765) 607-6161
Mailing address
3741 ROME DR, SUITE B, LAFAYETTE, IN 47905-4490
(765) 607-6160
(765) 607-6161
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01062400A
IN
208000000X
Pediatrics Physician
61002723
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01062400A
IN STATE LICENSE
IN
05
—
200908770
—
IN
01
—
61002723
LICENSE
NY
Enumeration date
09/22/2006
Last updated
10/15/2015
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