Provider Demographics
NPI:1295972032
Name:POPO-JAMES, ONIKA AYODELE (DO)
Entity type:Individual
Prefix:DR
First Name:ONIKA
Middle Name:AYODELE
Last Name:POPO-JAMES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ONIKA
Other - Middle Name:AYODELE
Other - Last Name:POPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:285 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7350
Mailing Address - Country:US
Mailing Address - Phone:770-507-1414
Mailing Address - Fax:770-507-5150
Practice Address - Street 1:285 COUNTRY CLUB DR
Practice Address - Street 2:SUITE 200
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7350
Practice Address - Country:US
Practice Address - Phone:770-507-1414
Practice Address - Fax:770-507-5150
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA818262915AMedicaid
GA202I089332Medicare PIN