Provider Demographics
NPI:1740350255
Name:AMOSU, OYEYEMI KIKELOMO (MD)
Entity type:Individual
Prefix:
First Name:OYEYEMI
Middle Name:KIKELOMO
Last Name:AMOSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OYEYEMI
Other - Middle Name:KIKELOMO
Other - Last Name:JOLAOSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:35 COLLIER RD NW STE 635
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1611
Mailing Address - Country:US
Mailing Address - Phone:770-719-5630
Mailing Address - Fax:770-719-5629
Practice Address - Street 1:1255 HIGHWAY 54 W
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:770-719-5630
Practice Address - Fax:770-719-5629
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58134207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine