Healthcare Provider Details

I. General information

NPI: 1154081412
Provider Name (Legal Business Name): AKIN AYENI MD AND ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2021
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 THE EXCHANGE SE STE 200
ATLANTA GA
30339-2021
US

IV. Provider business mailing address

1870 THE EXCHANGE SE STE 20026
ATLANTA GA
30339-2036
US

V. Phone/Fax

Practice location:
  • Phone: 770-829-7442
  • Fax:
Mailing address:
  • Phone: 770-829-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: AKINLAWON AYENI
Title or Position: OWNER
Credential: MD
Phone: 770-829-7442