MEDICARE: DR. OLABISI TITILOLA ODUKOYA 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	35.155568	OH

General Provider Information

NPI Number	:	1760892269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLABISI TITILOLA ODUKOYA M.D

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	888-987-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	10905 KINSMAN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-5062
Country	:	US
Telephone Number	:	216-769-9130
Fax Number	:	888-355-6714

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

Provider Enumeration Date	:	05/06/2014
Last Update Date	:	03/24/2026

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