Healthcare Provider Details

I. General information

NPI: 1619841830
Provider Name (Legal Business Name): OLAYIWOLA OJO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6849 WOODWARD WAY
PLAINFIELD IN
46168-8588
US

IV. Provider business mailing address

6849 WOODWARD WAY
PLAINFIELD IN
46168-8588
US

V. Phone/Fax

Practice location:
  • Phone: 317-640-0242
  • Fax:
Mailing address:
  • Phone: 317-640-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number250189231
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number250189231
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: