Provider Demographics
NPI:1508500414
Name:ABIOYE, ABIODUN JOSEPH (MD)
Entity Type:Individual
Prefix:MR
First Name:ABIODUN
Middle Name:JOSEPH
Last Name:ABIOYE
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 1:7301 ROGERS AVE
Mailing Address - Street 2:MERCY FORT SMITH ATTN GME DEPARTMENT
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4100
Mailing Address - Country:US
Mailing Address - Phone:479-314-6000
Mailing Address - Fax:479-314-4705
Practice Address - Street 1:7301 ROGERS AVE
Practice Address - Street 2:MERCY FORT SMITH
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4100
Practice Address - Country:US
Practice Address - Phone:479-314-6000
Practice Address - Fax:479-314-4705
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2023-02-08
Deactivation Date:2023-01-30
Deactivation Code:
Reactivation Date:2023-02-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program