NPI 1285167759 · live from the CMS NPI Registry
Olabode Agaja, D.O.
Pediatrics, Sports Medicine in Jefferson, LA. National Provider Identifier 1285167759, active.
NPI record
| NPI | 1285167759 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Sports Medicine 2080S0010X |
| Practice location | 1201 S Clearview Pkwy, Jefferson, LA 70121 |
| Practice phone | 504-736-4800 |
| Mailing address | 1514 Jefferson Hwy, New Orleans, LA 70121 |
| Enumerated | April 11, 2017 |
| Last updated | October 13, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — (MI) |
| Pediatrics, Sports Medicine primary | 2080S0010X | 327774 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.