Provider Demographics
NPI:1841629797
Name:ADIGUN, OLAJUMOKE BEULAH
Entity type:Individual
Prefix:
First Name:OLAJUMOKE
Middle Name:BEULAH
Last Name:ADIGUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 W GULFPORT ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-4238
Mailing Address - Country:US
Mailing Address - Phone:918-813-8978
Mailing Address - Fax:
Practice Address - Street 1:1820 W GULFPORT ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011-4238
Practice Address - Country:US
Practice Address - Phone:918-813-8978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program