Provider Demographics
NPI:1699752808
Name:BOLAJI, TOYIN F
Entity type:Individual
Prefix:
First Name:TOYIN
Middle Name:F
Last Name:BOLAJI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 LUDS WAY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-6341
Mailing Address - Country:US
Mailing Address - Phone:334-778-7090
Mailing Address - Fax:334-788-7085
Practice Address - Street 1:172 LUDS WAY
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-6341
Practice Address - Country:US
Practice Address - Phone:334-778-7090
Practice Address - Fax:334-788-7085
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-137792363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology