Provider Demographics
NPI:1376110916
Name:OGISO GROUP, LLC
Entity Type:Organization
Organization Name:OGISO GROUP, LLC
Other - Org Name:OGISO SKYCARE; OGISO HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER, FUNDER, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OLATUNDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MSPH
Authorized Official - Phone:615-887-4931
Mailing Address - Street 1:222 2ND AVE S STE 1700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-2376
Mailing Address - Country:US
Mailing Address - Phone:615-397-6243
Mailing Address - Fax:615-913-5929
Practice Address - Street 1:222 2ND AVE S STE 1700
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-2376
Practice Address - Country:US
Practice Address - Phone:615-397-6243
Practice Address - Fax:161-557-7014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports MedicineGroup - Multi-Specialty
No2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical ToxicologyGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty