| Adebukola Ajagunna, | |
|
4235 Fort Campbell Blvd, Hopkinsville, KY 42240-9339 | |
| (270) 885-8445 | |
| (270) 886-9106 |
| Full Name | Adebukola Ajagunna |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 4235 Fort Campbell Blvd, Hopkinsville, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215468541 | NPI | - | NPPES |
| 7100816390 | Medicaid | KY | |
| Q055938 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 56663 (Kentucky) | Secondary |
| 208000000X | Pediatrics | 60519 (Tennessee) | Primary |
| Entity Name | Vanderbilt Integrated Providers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982625091 PECOS PAC ID: 7012817919 Enrollment ID: O20040108001021 |
| Mailing Address | Practice Location Address |
|---|---|
| Adebukola Ajagunna, 3841 Green Hills Village Dr Ste 200, Nashville, TN 37215-2691 Ph: () - | Adebukola Ajagunna, 4235 Fort Campbell Blvd, Hopkinsville, KY 42240-9339 Ph: (270) 885-8445 |
Rachael-catherine Hartnett, APRN Pediatrics Medicare: Medicare Enrolled Practice Location: Vanderbilt Pediatric Associates, 4235 Fort Campbell Blvd, Hopkinsville, KY 42240 Phone: 270-885-8445 | |
Thomas H Price, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1717 High St, Suite 3a, Hopkinsville, KY 42240 Phone: 270-885-8445 Fax: 270-886-9106 | |
Jan Floyd, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 222 W 18th St, Hopkinsville, KY 42240 Phone: 270-886-4625 | |
Eliza Joyce Whitten-hoskins, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 105 Keeton Dr, Hopkinsville, KY 42240 Phone: 270-887-6565 Fax: 270-887-6575 | |
Duncan R Campbell, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 4235 Fort Campbell Blvd, Hopkinsville, KY 42240 Phone: 270-885-8445 Fax: 270-886-9106 | |
Cristina R Cruz, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1717 High St Ste 3a, Hopkinsville, KY 42240 Phone: 270-885-8445 Fax: 270-886-9106 |