MEDICARE: DR. JANET OLUFUNKEBASIRAT ADENIRAN DO

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	207Q00000X	Family Medicine Physician	2018-01561	NC

General Provider Information

NPI Number	:	1578980678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET OLUFUNKEBASIRAT ADENIRAN DO

Provider Business Mailing Address
First Line	:	6507 S COOPER ST STE 105
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-5818
Country	:	US
Telephone Number	:	817-466-9100
Fax Number	:	817-466-9410

Provider Business Practice Location Address
First Line	:	6507 S COOPER ST STE 105
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-5818
Country	:	US
Telephone Number	:	817-466-9100
Fax Number	:	817-466-9410

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

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	03/22/2024

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