MEDICARE: DR KAY OLUKAYODE OSO M.D. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center		GA

General Provider Information

NPI Number	:	1710368915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR KAY OLUKAYODE OSO M.D. PA

Provider Business Mailing Address
First Line	:	2727 PACES FERRY RD SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-4053
Country	:	US
Telephone Number	:	404-426-4665
Fax Number	:	404-521-4959

Provider Business Practice Location Address
First Line	:	2727 PACES FERRY RD SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-4053
Country	:	US
Telephone Number	:	404-426-4665
Fax Number	:	404-521-4959

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	KAY OLUKAYODE
Credential	:
Telephone Number	:	404-426-4665

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	06/12/2015

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