1013309236 NPI number — DR. TEMITOPE GABRIEL OLANIWUN PT,DPT

Table of content: DR. TEMITOPE GABRIEL OLANIWUN PT,DPT (NPI 1013309236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013309236 NPI number — DR. TEMITOPE GABRIEL OLANIWUN PT,DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLANIWUN
Provider First Name:
TEMITOPE
Provider Middle Name:
GABRIEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PT,DPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013309236
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9604 NW 126TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YUKON
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73099-9697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-706-7304
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3030 NW EXPRESSWAY
Provider Second Line Business Practice Location Address:
SUITE 809
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73112-5474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-848-8813
Provider Business Practice Location Address Fax Number:
866-848-8814
Provider Enumeration Date:
02/25/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  6258 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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