| Dr Olabode Olaosebikan Desalu, MD | |
|
900 S 52nd St Ste 200, Rogers, AR 72758-8640 | |
| (479) 254-1100 | |
| Not Available |
| Full Name | Dr Olabode Olaosebikan Desalu |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 900 S 52nd St Ste 200, Rogers, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093732950 | NPI | - | NPPES |
| 200069660 | Medicaid | MO | |
| 1470635 | Medicaid | LA | |
| 200775600A | Medicaid | OK | |
| 176387001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 15345R (Louisiana) | Secondary |
| 208000000X | Pediatrics | E-11228 (Arkansas) | Primary |
| 208000000X | Pediatrics | T2018-031 (Arkansas) | Secondary |
| Entity Name | Lsu Health Sciences Center Shreveport Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013374222 PECOS PAC ID: 4082902721 Enrollment ID: O20161012000307 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Olabode Olaosebikan Desalu, MD 1 Children's Way, Slot 844, Little Rock, AR 72202-3500 Ph: (501) 364-2090 | Dr Olabode Olaosebikan Desalu, MD 900 S 52nd St Ste 200, Rogers, AR 72758-8640 Ph: (479) 254-1100 |
Bryan M Harvey, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 900 S 52nd St, 200, Rogers, AR 72758 Phone: 479-254-1100 Fax: 479-254-2997 | |
Dr. Martha Ann B Sharkey, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5507 Walsh Ln, Suite 101, Rogers, AR 72758 Phone: 479-464-8231 Fax: 479-464-8230 | |
Dr. Virginia Brown Neaville, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2708 Rife Medical Lane, Suite 130, Rogers, AR 72758 Phone: 479-338-5555 Fax: 479-338-5533 | |
Dr. Matthew Cort Bell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 700 S 52nd St, Rogers, AR 72758 Phone: 479-464-8887 Fax: 479-464-9949 | |
Margaret Lafferty-oza, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2710 S Rife Medical Ln, Rogers, AR 72758 Phone: 479-636-0200 Fax: 479-986-3448 | |
Dr. Janet Susan Cantwell, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 900 S 52nd St, Suite 200, Rogers, AR 72758 Phone: 479-254-1100 Fax: 479-254-2997 |