MEDICARE: OLADAPO O OMITOWOJU 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
1	207RN0300X	Nephrology Physician	28014	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407848104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLADAPO O OMITOWOJU M.D.

Provider Business Mailing Address
First Line	:	408 42ND AVE N STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-3669
Country	:	US
Telephone Number	:	615-356-4111
Fax Number	:	615-356-8011

Provider Business Practice Location Address
First Line	:	1801 N WASHINGTON ST
Second Line	:	STE. 300
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-8245
Country	:	US
Telephone Number	:	931-393-4995
Fax Number	:	931-393-3573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	10/29/2025

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