| Bolaji S Sofola, MD | |
|
915 10th Ave Nw, Ardmore, OK 73401-4025 | |
| (580) 226-8310 | |
| (580) 223-3911 |
| Full Name | Bolaji S Sofola |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 35 Years |
| Location | 915 10th Ave Nw, Ardmore, Oklahoma |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366406217 | NPI | - | NPPES |
| 731521343 | Other | OK | FEDERAL TAX NUMBER |
| 100102400A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 18035 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mays Hospice Care, Inc | Antlers, OK | Hospice |
| Mercy Hospital Ardmore, Inc | Ardmore, OK | Hospital |
| Alliancehealth Durant | Durant, OK | Hospital |
| Onecore Health | Oklahoma city, OK | Hospital |
| Arbuckle Memorial Hospital | Sulphur, OK | Hospital |
| Chickasaw Nation Medical Center | Ada, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Urology Center Of Southern Oklahoma,pc | 0547257461 | 3 |
| Durant Hma Physician Management Llc | 3375638976 | 21 |
| Entity Name | Urology Center Of Southern Oklahoma,pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881609568 PECOS PAC ID: 0547257461 Enrollment ID: O20040430000390 |
| Entity Name | Durant Hma Physician Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043361116 PECOS PAC ID: 3375638976 Enrollment ID: O20070927000304 |
| Mailing Address | Practice Location Address |
|---|---|
| Bolaji S Sofola, MD Po Box 1571, Ardmore, OK 73402-1571 Ph: (580) 226-8310 | Bolaji S Sofola, MD 915 10th Ave Nw, Ardmore, OK 73401-4025 Ph: (580) 226-8310 |
Hayden D. Henry, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 915 10th Ave Nw, Ardmore, OK 73401 Phone: 580-226-8310 Fax: 580-223-3911 |