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NPI Code Detail

MEDICARE: DR. TIMOTHY ADESANYA MD

MEDICARE: DR. TIMOTHY ADESANYA MD
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
1207Q00000XFamily Medicine Physician35.144915OH

General Provider Information

NPI Number : 1215593090
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY ADESANYA MD
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-5123
Fax Number : 614-688-6491
Provider Business Practice Location Address
First Line : 2231 N HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-1194
Country : US
Telephone Number : 614-293-2700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2019
Last Update Date : 02/03/2026

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