Provider Demographics
NPI:1013189364
Name:AJAYI, JULIUS OLUKAYODE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:OLUKAYODE
Last Name:AJAYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 HORIZON PARK DR
Mailing Address - Street 2:SUITE B/C
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7252
Mailing Address - Country:US
Mailing Address - Phone:678-546-2840
Mailing Address - Fax:678-546-2844
Practice Address - Street 1:2930 HORIZON PARK DR
Practice Address - Street 2:SUITE B/C
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7252
Practice Address - Country:US
Practice Address - Phone:678-546-2840
Practice Address - Fax:678-546-2844
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA043843207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG54425Medicare UPIN
GA11BDTPCMedicare PIN