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Individual

DR. GAFAR AJANI ADESOJI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
8412 AIRWAYS BLVD, BUILDING C,SUITE 5B, SOUTHAVEN, MS 38671-5140
(662) 536-2100
(662) 536-2211
Mailing address
PO BOX 1078, SOUTHAVEN, MS 38671-0011
(662) 536-2100
(662) 536-2211

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16532
MS
207R00000X
Internal Medicine Physician
MD0000035864
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01724394
MS
Enumeration date
07/23/2006
Last updated
03/17/2021
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