Heritage Medical Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036658 Issued in GA

Legal business name

HERITAGE MEDICAL INC

Practice address

3300 Memorial Dr
Ste D4
Decatur, GA 30032-2700

Phone

(404) 289-2500

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Julius B Oderinde, MD

Title

Owner

Phone

(404) 289-2500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700975414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 MEMORIAL DR",
            "address_2": "STE D4",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322700",
            "telephone_number": "404-289-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MEMORIAL DR",
            "address_2": "STE D4",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322700",
            "telephone_number": "404-289-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ODERINDE",
        "authorized_official_first_name": "JULIUS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-289-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "036658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janequa Lashay Henson
• Matthew Hentschel
• Devin Hepker, LMSW
• Ayana Nicole Herbert, MD
• Lauren Heres
• Stephen H Herman
• Emily Ann Hermes, DPM
• Anissa Hernandez, MSW
• Jeranfel Hernandez, M.D.
• Tracie Herold, LCSW

• Family Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Family Medicine Physician in Georgia

• 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.