1528697653 NPI number — DR. OLUWATOBI OHIOLE OZOYA MD, MPH

Table of content: DR. OLUWATOBI OHIOLE OZOYA MD, MPH (NPI 1528697653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528697653 NPI number — DR. OLUWATOBI OHIOLE OZOYA MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OZOYA
Provider First Name:
OLUWATOBI
Provider Middle Name:
OHIOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OZOYA
Provider Other First Name:
TOBI
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, MPH
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1528697653
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 E PRESTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71105-2704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-841-9532
Provider Business Mailing Address Fax Number:
318-841-9547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 MCMILLAN RD
Provider Second Line Business Practice Location Address:
NULL
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-329-8830
Provider Business Practice Location Address Fax Number:
318-383-2332
Provider Enumeration Date:
04/01/2020

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: 207ZH0000X , with the licence number:  346135 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: 346135 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2694162 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com