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General NPI Number Information
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NPI Number | 1073780698
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Entity Type | Individual
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Provider Name | SUNDAY O. BANKOLE MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 7720 N 16TH ST SUITE 425
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City | PHOENIX
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State | AZ
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Zip | 85020-4492
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Country | US
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Telephone | 602-476-0800
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Fax | 602-476-8959
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Provider Business Mailing Address
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Address Line | 7720 N 16TH ST SUITE 425
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City | PHOENIX
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State | AZ
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Zip | 85020-4492
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Country | US
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Telephone | 602-476-0800
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Fax | 602-476-8959
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 43694
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License Number State | AZ
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