Individual
DR. AYODEJI ODUOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
(765) 838-4698
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101252866
VA
208M00000X
Hospitalist Physician
01071055A
IN
208M00000X
Hospitalist Physician
Primary
MD188608
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000766029
ANTHEM PROVIDER NUMBER
IN
05
—
201063890
—
IN
Enumeration date
01/08/2010
Last updated
10/30/2025
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