Provider Demographics
NPI:1104387760
Name:AKINOLA, KEIDE KERRICK (MD)
Entity type:Individual
Prefix:
First Name:KEIDE
Middle Name:KERRICK
Last Name:AKINOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5354 REYNOLDS ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6009
Mailing Address - Country:US
Mailing Address - Phone:912-352-0920
Mailing Address - Fax:912-826-2853
Practice Address - Street 1:5354 REYNOLDS ST STE 202
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6009
Practice Address - Country:US
Practice Address - Phone:912-352-0920
Practice Address - Fax:912-826-2853
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA105448208600000X
ALMD.49573208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery