Individual
DR. AARON PATRICK OMOTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4 MEMORIAL DR STE 130B, ALTON, IL 62002-6704
(618) 463-7600
(618) 463-7601
Mailing address
4 MEMORIAL DR STE 130B, ALTON, IL 62002-6704
(618) 463-7600
(618) 463-7601
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-125644
IL
207X00000X
Orthopaedic Surgery Physician
MD.LSU.ORS
LA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036125644
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2010011917
MO
Other
Enumeration date
03/14/2008
Last updated
01/14/2022
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