Individual provider · NPI-1

Dr. Ezekiel Oladejo Adetunji, MD

Family Medicine · Jackson, TN

NPI number1033302013
StatusActive
Last updated in NPPESFeb 5, 2020

Details

NPI
1033302013
Entity type
Individual (NPI-1)
Name
Dr. Ezekiel Oladejo Adetunji
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 22, 2007
Certification date
Feb 5, 2020
Last updated
Feb 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine44164TNYes
207Q00000X Family Medicine001924GA

Practice location

150 Murray Guard Dr
Jackson, TN 38305-3609

Phone 731-300-3168 · Fax 731-300-3169

Mailing address

139 Stonebridge Blvd
Jackson, TN 38305-2040

Phone 731-300-3168 · Fax 731-300-3169

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