Healthcare Provider Details

I. General information

NPI: 1619154499
Provider Name (Legal Business Name): ATKINSON GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FARRINGTON WAY APT C
COLUMBIA SC
29210-6075
US

IV. Provider business mailing address

1400 FARRINGTON WAY APT C
COLUMBIA SC
29210-6075
US

V. Phone/Fax

Practice location:
  • Phone: 803-647-4510
  • Fax:
Mailing address:
  • Phone: 803-647-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. AKINSOLA KINGS OJO
Title or Position: GENERAL MANAGER
Credential: MD
Phone: 803-647-4510