Healthcare Provider Details

I. General information

NPI: 1346229069
Provider Name (Legal Business Name): MORAKINYO A. O. TONEY MD..
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 CREEK BLF
MARTINEZ GA
30907-8962
US

IV. Provider business mailing address

514 CREEK BLF
MARTINEZ GA
30907-8962
US

V. Phone/Fax

Practice location:
  • Phone: 706-787-2060
  • Fax: 706-787-0302
Mailing address:
  • Phone: 707-854-0371
  • Fax: 706-787-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD-11367
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: