Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Olatunji Jonathan Oluwatade, MD

Individual provider Internal Medicine Physician · NPI 1477677458

Dr. Olatunji Jonathan Oluwatade, MD is an Emergency Medicine in Vicksburg, Mississippi. Qualified in 1987, 39 years ago. Practices with Kcc Infusion, LLC, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan and Mississippi.

Years since qualifying
39
Licensed in
MI, MS
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2080 S Frontage Rd SUITE100
Vicksburg, MS 39180-5883
Phone: (601) 262-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 971 Lakeland Dr Ste 954, Jackson, MS 39216-4609 — (601) 200-4714

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X · Licence 19904 (MS)
Internal Medicine Physician Taxonomy 207R00000X · Licence 4301089363 (MI)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 19904 (MS)
Hospitalist Physician Taxonomy 208M00000X · Licence 19904 (MS)

Record details

NPI number1477677458
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 16, 2007
Last updated in NPPESMarch 13, 2024
Certification dateMarch 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Kcc Infusion, Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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