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General NPI Number Information
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NPI Number | 1053016899
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Entity Type | Individual
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Provider Name | KYLE SATOSHI OI MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1364 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-1767
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Country | US
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Telephone | 404-778-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 2470 RIDGEFIELD TER
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City | DECATUR
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State | GA
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Zip | 30033-4211
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Country | US
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Telephone | 949-338-7054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 102033
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License Number State | GA
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