Dr Ademola Shofoluwe, MD | |
3211 Iris Dr, Covington, GA 30016-0907 | |
(770) 787-4042 | |
(770) 922-7499 |
Full Name | Dr Ademola Shofoluwe |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 3211 Iris Dr, Covington, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972039022 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 96429 (Georgia) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | T7041 (Texas) | Secondary |
Entity Name | Ortholonestar Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942860176 PECOS PAC ID: 9931529062 Enrollment ID: O20201012001450 |
Mailing Address | Practice Location Address |
---|---|
Dr Ademola Shofoluwe, MD 3211 Iris Dr, Covington, GA 30016-0907 Ph: (770) 787-4042 | Dr Ademola Shofoluwe, MD 3211 Iris Dr, Covington, GA 30016-0907 Ph: (770) 787-4042 |
Brett Michael Rosenberg, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 5303 Adams St Ne Ste A, Covington, GA 30014 Phone: 706-549-1663 Fax: 706-546-8792 | |
Jimmy A. Spivey, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 5303 Adams St Ne, Ste A, Covington, GA 30014 Phone: 706-549-1663 Fax: 706-546-8792 | |
Dr. Clifton Gregrory Meals, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 4181 Hospital Dr Ne Ste 204, Covington, GA 30014 Phone: 678-766-8999 Fax: 678-625-2168 | |
Tarek A Nessouli, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 3211 Iris Drive, Covington, GA 30016 Phone: 770-787-4042 Fax: 770-787-4001 | |
Dr. Matt Mathew, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 4181 Hospital Dr Ne Ste 204, Covington, GA 30014 Phone: 678-766-8999 | |
Dr. Jane Soon-yuen Tan, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 3211 Iris Dr, Covington, GA 30016 Phone: 770-787-4042 Fax: 770-922-7499 | |
Dr. Robert T. Greenfield, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 3211 Iris Dr, Covington, GA 30016 Phone: 770-787-4042 Fax: 770-787-4001 |