Provider Demographics
NPI:1285667840
Name:OSUNTOKUN, OLADAPO RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:OLADAPO
Middle Name:RICHARD
Last Name:OSUNTOKUN
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 1:510 SKYLINE DR S
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9146
Mailing Address - Country:US
Mailing Address - Phone:570-585-5481
Mailing Address - Fax:570-344-1178
Practice Address - Street 1:1615 E ELM ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-3925
Practice Address - Country:US
Practice Address - Phone:570-342-8305
Practice Address - Fax:570-344-1178
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4274752084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD427475OtherPHYSICIAN LICENSE