Provider Demographics
NPI:1295196160
Name:AMON, OLUYINKA JOANNETT (DO)
Entity Type:Individual
Prefix:DR
First Name:OLUYINKA
Middle Name:JOANNETT
Last Name:AMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 MEYERS LN
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4915
Mailing Address - Country:US
Mailing Address - Phone:808-451-6871
Mailing Address - Fax:
Practice Address - Street 1:1593 MEYERS LN
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4915
Practice Address - Country:US
Practice Address - Phone:808-451-6871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01022027210174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist