Provider Demographics
NPI:1295706976
Name:AINA, OLAYINKA OLUSOLA (MD)
Entity type:Individual
Prefix:MR
First Name:OLAYINKA
Middle Name:OLUSOLA
Last Name:AINA
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 1:154 ELLIOTT AVE
Mailing Address - Street 2:
Mailing Address - City:PEEBLES
Mailing Address - State:OH
Mailing Address - Zip Code:45660
Mailing Address - Country:US
Mailing Address - Phone:937-587-2618
Mailing Address - Fax:937-587-2288
Practice Address - Street 1:154 ELLIOTT AVE
Practice Address - Street 2:
Practice Address - City:PEEBLES
Practice Address - State:OH
Practice Address - Zip Code:45660
Practice Address - Country:US
Practice Address - Phone:937-587-2618
Practice Address - Fax:937-587-2288
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35063874207P00000X, 207R00000X
KY56256207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000039091OtherANTHEM
OH0919939Medicaid
31142259400OtherBWC
KY64953763Medicaid
AI0738801Medicare ID - Type Unspecified
F13206Medicare UPIN