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Individual

DR. ADEYINKA ADEBAYO AGBETOYIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2968 NORTH HIGHLAND AVE, JACKSON, TN 38305
(731) 256-1819
(731) 664-4330
Mailing address
2968 NORTH HIGHLAND AVENUE, SUITE A, JACKSON, TN 38305-3609
(731) 256-1819
(731) 664-4330

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36918
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4160707
BLUE CROSS BLUE SHIELD
TN
01
41719
TLC
TN
01
7638433
AETNA
01
87726
UNITED HEALTH
TN
01
P00440784
RAILROAD MEDICARE
TN
Enumeration date
06/06/2006
Last updated
04/28/2024
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