NPIMap

Organization Active NPI

Olakunle D. Ajanaku, MD. PC.

  • Internal Medicine Physician
  • Okmulgee, OK
National Provider Identifier
1891905550
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18655 Issued in OK
Legal business name
OLAKUNLE D. AJANAKU, MD. PC.
Practice address
1101 S Belmont Ave
Suite 104
Okmulgee, OK 74447-6315
Phone
(918) 758-3536
Fax
(918) 758-3537
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Authorized official

Name
Olakunle D Ajanaku, M.D.
Title
Owner
Phone
(918) 758-3536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 18655 OK Primary

Addresses

Primary practice location

1101 S Belmont Ave
Suite 104
Okmulgee, OK 74447-6315

Mailing address

1101 S Belmont Ave
Suite 104
Okmulgee, OK 74447-6315
Phone (918) 758-3536

Other identifiers 4

IdentifierTypeStateIssuer
100002630DMedicaidOK
100002630FMedicaidOK
5030315OtherOKAETNA
030662440003OtherOKBCBS

National Provider Directory

National Provider Directory

Locations

1101 S Belmont Ave
Ste 104
Okmulgee, OK 74447
Phone (918) 758-3536

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1891905550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S BELMONT AVE",
            "address_2": "SUITE 104",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476315",
            "telephone_number": "918-758-3536",
            "fax_number": "918-758-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S BELMONT AVE",
            "address_2": "SUITE 104",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476315",
            "telephone_number": "918-758-3536",
            "fax_number": "918-758-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLAKUNLE D. AJANAKU, MD. PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "AJANAKU",
        "authorized_official_first_name": "OLAKUNLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-758-3536",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002630D",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002630F",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5030315",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "030662440003",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okmulgee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.