Provider Demographics
NPI:1093043986
Name:OLOBATUYI, RICHARD BODUNDE (LPN)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:BODUNDE
Last Name:OLOBATUYI
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 MARGO RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5769
Mailing Address - Country:US
Mailing Address - Phone:614-880-9057
Mailing Address - Fax:
Practice Address - Street 1:2010 MARGO RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5769
Practice Address - Country:US
Practice Address - Phone:614-880-9057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN117378164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse