Healthcare Provider Details

I. General information

NPI: 1174553226
Provider Name (Legal Business Name): FREDRICK ADELANA ONI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WATSON BLVD
WARNER ROBINS GA
31093-3632
US

IV. Provider business mailing address

1700 WATSON BLVD
WARNER ROBINS GA
31093-3632
US

V. Phone/Fax

Practice location:
  • Phone: 478-922-2930
  • Fax: 478-922-2774
Mailing address:
  • Phone: 478-922-2930
  • Fax: 478-922-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number247502
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number247502
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number044560
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: