Individual
ADEWALE ADEYINKA ODUKOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 410-0367
Mailing address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 410-0367
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2020010832
MO
207P00000X
Emergency Medicine Physician
51712
KY
207P00000X
Emergency Medicine Physician
56635
TN
207P00000X
Emergency Medicine Physician
Primary
S5721
TX
207Q00000X
Family Medicine Physician
56635
TN
207R00000X
Internal Medicine Physician
51712
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
S5721
TX
Other
Enumeration date
03/23/2016
Last updated
01/19/2024
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