Medic One LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

51736 Issued in GA

Legal business name

MEDIC ONE LLC

Practice address

2621 Sandy Plains Rd
Suite 304
Marietta, GA 30066-4267

Phone

(770) 894-3167

Fax

(770) 575-0879

NPI assigned

May 8, 2012

Organization subpart

No

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

Authorized official

Name

Adesupo Oshiyoye

Title

Treasurer

Phone

(770) 894-3167

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1255690475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670508",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300660126",
            "telephone_number": "770-894-3167",
            "fax_number": "770-575-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 SANDY PLAINS RD",
            "address_2": "SUITE 304",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664267",
            "telephone_number": "770-894-3167",
            "fax_number": "770-575-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC ONE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "OSHIYOYE",
        "authorized_official_first_name": "ADESUPO",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "770-894-3167"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "51736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.