Healthcare Provider Details

I. General information

NPI: 1134617400
Provider Name (Legal Business Name): ROCHELLE TAADE THOMPSON KOLAWOLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

V. Phone/Fax

Practice location:
  • Phone: 334-749-3411
  • Fax:
Mailing address:
  • Phone: 334-749-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD.50144
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD.50144
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: