| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KOFOWOROLA MARIAM KUBOYE | 1225298011 | 2024-07-05 |
Kofoworola Mariam Kuboye is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225298011. Registration indicates Kofoworola Mariam Kuboye is a provider of access to pediatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Pediatrics (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics: Adolescent Medicine, ) (Specialist Network, ) (Pediatrics Adolescent Medicine, Allopathic & Osteopathic Physicians) (Pediatrics, ) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Pediatrics) (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians)
| Entity Type | Individual |
| Provider Name | Kofoworola Mariam Kuboye M.D |
| Practice Office Address | 1208 BENT OAKS CT DENTON, TX US |
| Practice Office Telephone | 9405665437 |
| Practice Office Fax | 9403230553 |
| Mailing Address | 1208 BENT OAKS CT DENTON, TX 762103300 US |
| Business Telephone | 9405665437 |
| Business Fax | 9403230553 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2701 Davis St | Meridian, MS 393015708 | 6016930118 / 6014838803 |
| Code | Practice | License No State |
|---|---|---|
| 2080A0000X | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics: Adolescent Medicine Specialist Network Pediatrics Adolescent Medicine Allopathic & Osteopathic Physicians Pediatrics | 21756
MS |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 208000000X PRIMARY | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | Q6050
TX |