Provider Demographics
NPI:1699296079
Name:ADELEKE, OMOLORO NADIA (MD)
Entity type:Individual
Prefix:DR
First Name:OMOLORO
Middle Name:NADIA
Last Name:ADELEKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:OMOLORO
Other - Middle Name:NADIA
Other - Last Name:ADEBAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4566 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6540
Mailing Address - Country:US
Mailing Address - Phone:601-496-9600
Mailing Address - Fax:
Practice Address - Street 1:4566 S EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6540
Practice Address - Country:US
Practice Address - Phone:601-496-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS312052080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty