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General NPI Number Information
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NPI Number | 1285667840
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Entity Type | Individual
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Provider Name | OLADAPO RICHARD OSUNTOKUN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1615 E ELM ST
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City | SCRANTON
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State | PA
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Zip | 18505-3925
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Country | US
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Telephone | 570-342-8305
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Fax | 570-344-1178
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Provider Business Mailing Address
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Address Line | 510 SKYLINE DR S
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City | CLARKS SUMMIT
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State | PA
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Zip | 18411-9146
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Country | US
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Telephone | 570-585-5481
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Fax | 570-344-1178
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD427475
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License Number State | PA
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