MEDICARE: ADEOLA AYOOLA

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
1	207UN0902X	Nuclear Imaging & Therapy Physician	14268768-1252	UT
2	2085R0202X	Diagnostic Radiology Physician	14268768-1252	UT

General Provider Information

NPI Number	:	1689510851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEOLA AYOOLA

Provider Business Mailing Address
First Line	:	50 N MEDICAL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-0001
Country	:	US
Telephone Number	:	801-581-7553
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 N MEDICAL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-0001
Country	:	US
Telephone Number	:	801-581-7553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	05/22/2026

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Directions to “ ADEOLA AYOOLA ” Practice Location

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