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General NPI Number Information
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NPI Number | 1790929859
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Entity Type | Individual
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Provider Name | EDWARD KOJO-EYIAH KOOMSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 425 W 3RD AVE STE 700
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City | ALBANY
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State | GA
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Zip | 31701-1969
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Country | US
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Telephone | 229-312-7790
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Fax | 229-312-7795
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Provider Business Mailing Address
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Address Line | 1000 N LEE AVE ROOM 4404
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-1036
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Country | US
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Telephone | 405-272-6406
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Fax | 405-272-6075
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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 | 28989
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 076035
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License Number State | GA
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