Oluwaseun Abayomi Oguntuase, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1125 N College Ave # Slot100
Fayetteville, AR 72703-1908

Phone

(479) 713-8310

NPI assigned

Mar 31, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1003619347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 W CEDAR CIR APT 3",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563077",
            "telephone_number": "407-912-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N COLLEGE AVE # SLOT100",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031908",
            "telephone_number": "479-713-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNTUASE",
        "first_name": "OLUWASEUN",
        "middle_name": "ABAYOMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Odyssey Healthcare Operating a LP
• Marjorie Ready Oelke
• Kyler Todd Offenbacker, PT, DPT
• Rita Lois Officer, PSYD
• Russell Oglee, PHARM.D.
• Chioma Okoroafor
• Chinwendu Ogechi Kaye Okoronkwo
• Cory Michael Oldham, D.C.
• Craig Olienyk, LAC
• Erin Oliver, MS, CCC-SLP

• Student in an Organized Health Care Education/Training Program in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Student in an Organized Health Care Education/Training Program in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.