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General NPI Number Information
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NPI Number | 1063069797
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Entity Type | Organization
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Legal Business Name | OMS URGENT CARE INC
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 2145 ROSWELL RD STE 60
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City | MARIETTA
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State | GA
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Zip | 30062-0819
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Country | US
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Telephone | 248-390-0241
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Fax |
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Provider Business Mailing Address
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Address Line | 2145 ROSWELL RD STE 60
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City | MARIETTA
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State | GA
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Zip | 30062-0819
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Country | US
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Telephone | 770-672-6267
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. OMOKHUALE OMOKHODION
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Credential | MD
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Telephone | 770-672-6267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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