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General NPI Number Information
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NPI Number | 1518051390
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Entity Type | Individual
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Provider Name | JOHN OMOZUAVBO OYAKHIRE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 1011 RIVER RIDGE DR APT 24C
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City | AUGUSTA
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State | GA
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Zip | 30909-2238
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Country | US
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Telephone | 217-721-1359
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 RIVER RIDGE DR APT 24C
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City | AUGUSTA
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State | GA
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Zip | 30909-2238
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Country | US
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Telephone | 217-721-1359
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 49205
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 102763
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License Number State | MN
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