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NPI Code Detail

MEDICARE: OLUFUNTO SOKOYA PHAMR D

MEDICARE: OLUFUNTO SOKOYA PHAMR D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPST.017630LA

General Provider Information

NPI Number : 1629365390
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLUFUNTO SOKOYA PHAMR D
Provider Business Mailing Address
First Line : 1101 NORTH TRENTON STREET
Second Line :
City : RUSTON
State : LA
Zip : 71270
Country : US
Telephone Number : 318-254-8731
Fax Number :
Provider Business Practice Location Address
First Line : 1401 N TRENTON ST
Second Line :
City : RUSTON
State : LA
Zip : 71270-2325
Country : US
Telephone Number : 318-254-8731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2011
Last Update Date : 07/01/2011

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Directions to “ OLUFUNTO SOKOYA PHAMR D” Practice Location

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