| Ijb Healthcare Services, Pc | |
|
4780a Ashford Dunwoody Rd Suite 621 Atlanta GA 30338-5504 | |
| (770) 331-8035 | |
| (770) 458-1596 |
| Full Name | Ijb Healthcare Services, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4780a Ashford Dunwoody Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Olugbemiga A. Osoba (OWNER) |
| Authorized Official Contact | 7703318035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ijb Healthcare Services, Pc 4780a Ashford Dunwoody Rd Suite 621 Atlanta GA 30338-5504 Ph: (770) 331-8035 | Ijb Healthcare Services, Pc 4780a Ashford Dunwoody Rd Suite 621 Atlanta GA 30338-5504 Ph: (770) 331-8035 |
| NPI Number | 1659691681 |
|---|---|
| Provider Enumeration Date | 06/01/2010 |
| Last Update Date | 07/26/2010 |
| Medicare PECOS PAC ID | 9638201148 |
|---|---|
| Medicare Enrollment ID | O20100720000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659691681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 059300 (Georgia) | Primary |
| Provider Name | Olugbemiga Osoba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578623443 PECOS PAC ID: 3375518087 Enrollment ID: I20090106000255 |
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