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NPI Code Detail

MEDICARE: DR. SIFAU YETUNDE OLADIPO M.D.

MEDICARE: DR. SIFAU YETUNDE OLADIPO M.D.
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
1207P00000XEmergency Medicine PhysicianE-12083AR
2207Q00000XFamily Medicine PhysicianE-12083AR
3208M00000XHospitalist PhysicianT4812TX

General Provider Information

NPI Number : 1336675123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIFAU YETUNDE OLADIPO M.D.
Provider Business Mailing Address
First Line : 3417 U OF A WAY
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-1419
Country : US
Telephone Number : 870-779-6000
Fax Number : 870-779-6093
Provider Business Practice Location Address
First Line : 300 E 6TH ST
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-5207
Country : US
Telephone Number : 870-779-6000
Fax Number : 870-779-6093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 03/27/2026

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