NPIMap

Organization Active NPI

Milestone Family Medicine

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1114976743
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
050325 Issued in GA
Legal business name
MILESTONE FAMILY MEDICINE
Practice address
1438 McLendon Dr
Decatur, GA 30033-1802
Phone
(770) 414-0337
Fax
(770) 414-0354
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Obafemi Oluseun Okuwobi, MD
Title
President
Phone
(770) 414-0337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 050325 GA Primary

Addresses

Primary practice location

1438 McLendon Dr
Decatur, GA 30033-1802

Mailing address

PO Box 15531
Atlanta, GA 30333-0531
Phone (770) 414-0337

National Provider Directory

National Provider Directory

Locations

1438 McLendon Dr
Decatur, GA 30033
Phone (770) 414-0337

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114976743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15531",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303330531",
            "telephone_number": "770-414-0337",
            "fax_number": "770-414-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 MCLENDON DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331802",
            "telephone_number": "770-414-0337",
            "fax_number": "770-414-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OKUWOBI",
        "authorized_official_first_name": "OBAFEMI",
        "authorized_official_middle_name": "OLUSEUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-414-0337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "050325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.