Healthcare Provider Details

I. General information

NPI: 1679720437
Provider Name (Legal Business Name): MOROHUNRANTI OKUNLOLAMIWA OGUNTOYE-OUMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOROHUNRANTI OKUNLOLAMIWA OGUNTOYE MD

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 11/30/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 JOHNSON FY RD NE STE 140
ATLANTA GA
30342-2130
US

IV. Provider business mailing address

1100 JOHNSON FY RD NE STE 140
ATLANTA GA
30342-2130
US

V. Phone/Fax

Practice location:
  • Phone: 404-531-9988
  • Fax: 404-953-4040
Mailing address:
  • Phone: 404-531-9988
  • Fax: 404-953-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number64166
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number64166
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: