Provider Demographics
NPI:1013041144
Name:AKINSOTO, OLAKUNLE PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:OLAKUNLE
Middle Name:PHILIP
Last Name:AKINSOTO
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 1:1201 7TH SEST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3337
Mailing Address - Country:US
Mailing Address - Phone:256-341-2909
Mailing Address - Fax:256-341-3053
Practice Address - Street 1:1201 7TH SEST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3337
Practice Address - Country:US
Practice Address - Phone:256-341-2909
Practice Address - Fax:256-341-3053
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025151207R00000X
AL25151208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911271Medicaid
AL109049Medicaid
AL515-97239OtherBCBS
AL109049Medicaid
AL009911271Medicaid
AL051558882Medicare PIN
AL510I110425Medicare PIN