Provider Demographics
NPI:1831115419
Name:AKINWUMIJU, OLAYINKA OLANIYI (MD)
Entity Type:Individual
Prefix:
First Name:OLAYINKA
Middle Name:OLANIYI
Last Name:AKINWUMIJU
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 1:8130 COUNTRY VILLAGE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2087
Mailing Address - Country:US
Mailing Address - Phone:901-308-2915
Mailing Address - Fax:901-308-2924
Practice Address - Street 1:8130 COUNTRY VILLAGE DR STE 102
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016
Practice Address - Country:US
Practice Address - Phone:901-308-2915
Practice Address - Fax:901-308-2924
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS169502084P0800X
TN408102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521381Medicaid
MS302I264225Medicaid
TN103I263512OtherMEDICARE TN
AR195422001Medicaid
MS302I264225OtherMEDICARE MS
MS06729219Medicaid