Provider Demographics
NPI:1699364182
Name:ACCIDENT INJURY MD
Entity Type:Organization
Organization Name:ACCIDENT INJURY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUJIMI
Authorized Official - Middle Name:I
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:770-366-9614
Mailing Address - Street 1:505 LEIGHTON WOODS CT
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-5534
Mailing Address - Country:US
Mailing Address - Phone:770-366-9614
Mailing Address - Fax:
Practice Address - Street 1:505 LEIGHTON WOODS CT
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-5534
Practice Address - Country:US
Practice Address - Phone:770-366-9614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty