Provider Demographics
NPI:1821316571
Name:IYOYO, MELISSA O'CONNOR (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:O'CONNOR
Last Name:IYOYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MAY
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-1224
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:500 MEDICAL CENTER BLVD STE 250
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3402
Practice Address - Country:US
Practice Address - Phone:770-979-4700
Practice Address - Fax:770-979-1060
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76578207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012367900Medicaid
FL012367900Medicaid