Olofinlade, Olusola
Olofinlade, Olusola is an individual health care provider with primary practice located at 701 E Marshall Ave Ste. 200, Longview TX 75601-5573. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Olofinlade, Olusola can be contacted via phone (903) 236-2222.Contact Information
Primary practice address
701 E Marshall Ave Ste. 200
Longview TX 75601-5573
Phone: (903) 236-2222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | L2520 | Texas |
Profile Details
| NPI number | 1093750531 |
|---|---|
| LBN Legal business name | Olofinlade, Olusola |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Feb 11th, 2011 - about 13 years ago |
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 | 1093750531 | NPPES |
| Texas | MEDICAID | 145747502 |
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