Individual
OLUFUNSO W ODUNUKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 WILLOW CREEK RD STE 2200, PRESCOTT, AZ 86301-1614
(928) 445-6025
(928) 778-3026
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5874
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
20655
NV
207RI0011X
Interventional Cardiology Physician
Primary
65997
AZ
207RI0011X
Interventional Cardiology Physician
80736
GA
208M00000X
Hospitalist Physician
8441
SD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250011662
—
NV
01
—
65997
ARIZONA MEDICAL BOARD
AZ
Enumeration date
07/30/2009
Last updated
03/07/2023
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