Provider Demographics
NPI:1124810684
Name:FANIYI, OLUWATOBI AYODELE (MD)
Entity type:Individual
Prefix:MR
First Name:OLUWATOBI
Middle Name:AYODELE
Last Name:FANIYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH STREET,MS 9406 TTUHSC DEPARTMENT OF PEDIATRICS
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430
Mailing Address - Country:US
Mailing Address - Phone:806-743-1798
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH STREET,MS 9406 TTUHSC DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430
Practice Address - Country:US
Practice Address - Phone:806-743-1798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program