Individual
A. O'TAYO LALUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
304 LINDBROOK ST, HENDERSON, NV 89074-5087
(502) 494-1725
Mailing address
304 LINDBROOK ST, HENDERSON, NV 89074-5087
(502) 494-1725
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
21661
KY
208D00000X
General Practice Physician
Primary
21661
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64216617
—
KY
Enumeration date
05/19/2006
Last updated
01/12/2022
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