Provider Demographics
NPI:1003859885
Name:AKANDE, EZEKIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:EZEKIEL
Middle Name:
Last Name:AKANDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 LANGDON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503
Mailing Address - Country:US
Mailing Address - Phone:606-677-0683
Mailing Address - Fax:606-677-0694
Practice Address - Street 1:355 LANGDON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2792
Practice Address - Country:US
Practice Address - Phone:606-677-0683
Practice Address - Fax:606-677-0069
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42021207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine