Odunukan, Olufunso W
Odunukan, Olufunso W is an individual health care provider with primary practice located at 1001 Willow Creek Rd Ste 2200 , Prescott AZ 86301-1614. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Hospitalist, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Odunukan, Olufunso W can be contacted via phone (928) 445-6025.Contact Information
Primary practice address
1001 Willow Creek Rd Ste 2200
Prescott AZ 86301-1614
Phone: (928) 445-6025
Fax: (928) 778-3026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 20655 | Nevada |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 80736 | Georgia |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 8441 | South Dakota |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 65997 | Arizona |
Profile Details
| NPI number | 1780815308 |
|---|---|
| LBN Legal business name | Odunukan, Olufunso W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2009 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780815308 | NPPES |
| Nevada | MEDICAID | 250011662 | |
| Nevada | Other | 65997 |
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