Provider Demographics
NPI:1790929859
Name:KOOMSON, EDWARD KOJO-EYIAH (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:KOJO-EYIAH
Last Name:KOOMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 N LEE AVE
Mailing Address - Street 2:ROOM 4404
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1036
Mailing Address - Country:US
Mailing Address - Phone:405-272-6406
Mailing Address - Fax:405-272-6075
Practice Address - Street 1:425 W 3RD AVE STE 700
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1969
Practice Address - Country:US
Practice Address - Phone:229-312-7790
Practice Address - Fax:229-312-7795
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK28989208M00000X
GA076035207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist