Provider Demographics
NPI:1629360961
Name:ISHOLA, ABIODUN OLAYINKA (MD)
Entity Type:Individual
Prefix:
First Name:ABIODUN
Middle Name:OLAYINKA
Last Name:ISHOLA
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:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-655-9500
Mailing Address - Fax:859-655-3077
Practice Address - Street 1:711 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3439
Practice Address - Country:US
Practice Address - Phone:859-287-3045
Practice Address - Fax:859-578-3800
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51104207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology