OMOBOLAJI OLUSEYI OYEBANJO POPOOLA


Address: 307 Old Stone Rd, Villa Rica, GA 30180-1214
Phone: 7704598799

OMOBOLAJI OLUSEYI OYEBANJO POPOOLA (NPI# 1578754503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578754503
Entity Type Individual
Full Name OMOBOLAJI OLUSEYI OYEBANJO POPOOLA
Credential MD
Practice Address 307 Old Stone Rd
Villa Rica
GA 30180-1214
Practice Telephone 7704598799
Practice Fax Number 7704598919
Mailing Telephone 7704598799
Mailing Fax Number 7704598919
Enumeration Date 2007-08-06
Last Update Date 2019-11-21
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0802X Psychiatry & Neurology
Specialization: Addiction Psychiatry
053509 GA Allopathic & Osteopathic Physicians

Office Location

Street Address 307 OLD STONE RD
City VILLA RICA
State GA
Zip Code 30180-1214

Providers in the same location

NPI Name Taxonomy Address Enumeration
1740769538 Khadeja Chowdhury Physician Assistant 307 Old Stone Rd, Villa Rica, GA 30180 2018-08-13
1760932685 Mardeea Jartu Counselor 307 Old Stone Rd, Villa Rica, GA 30180-1214 2016-10-04
1700209327 Larry Dewitt Fuller Jr. Counselor 307 Old Stone Rd, Villa Rica, GA 30180-1214 2014-02-03
1881967677 April C Thomas Counselor 307 Old Stone Rd, Villa Rica, GA 30180-1214 2012-02-09
1386964690 Potters Hands Institute LLC Clinic/Center 307 Old Stone Rd, Villa Rica, GA 30180-1214 2010-06-09
1922280684 Mobolaji Shalom Oyebanjo, Inc Clinic/Center 307 Old Stone Rd, Villa Rica, GA 30180-1214 2007-12-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174161624 Crucible Communication Therapy LLC Speech-Language Pathologist 9765 Walnut Grove Trail, Villa Rica, GA 30180 2019-12-16
1366802845 Medic-pearl, LLC Ambulance 1108 Charter Oak Ct, Villa Rica, GA 30180 2016-02-26
1396138368 Josette Etienne Nurse Practitioner 403 Permian Way Suite A, Villa Rica, GA 30180 2015-03-13
1447690516 Judith L.m. Thigpen Nurse Practitioner 736 Highway 78 West, Minute Clinic, Villa Rica, GA 30180 2013-07-03
1477890168 Wesley Douglas Mckenzie Pharmacist 2500 Mirror Lake Blvd, Villa Rica, GA 30180 2013-01-15
1497005359 Malika Remie Rajendra Optometrist 600 Hwy 61, Villa Rica, GA 30180 2012-09-18
1972876449 Catherine Elaine Tyson Pharmacist 601 Dallas Road, Villa Rica, GA 30180 2012-02-14
1619262433 Villa Rica Rx LLC Pharmacy 222 West Wilson Street, Villa Rica, GA 30180 2011-06-09
1851602874 Jules Chopin Sybert Nurse Practitioner 736 W. Bankhead Hwy, Villa Rica, GA 30180 2010-06-24
1487984019 Lisa Wood Occupational Therapy Assistant 1207 Woods Walk, Villa Rica, GA 30180 2010-01-04
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Taxonomy Information

Taxonomy Code 2084P0802X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Addiction Psychiatry

Taxonomy Definition

Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1821393380 Tifton Addiction Associates, LLC. D/b/a Tlc Clinic Psychiatry & Neurology 2402 North Tift Ave Suite 202, Tifton, GA 31794 2011-01-14
1760517254 Todd Estroff Psychiatry & Neurology 627 Old Ivy Rd Ne, Atlanta, GA 30342-4319 2007-02-23
1861534802 Joseph Francis Griffin IIi Psychiatry & Neurology 1677 East Clifton Rd, Atlanta, GA 30307-1289 2007-02-13
1346253309 John L Moseri Psychiatry & Neurology 4540 Glenwood Rd, Decatur, GA 30032-5166 2006-08-14
1710997069 Ayman Mohsen Fareed Psychiatry & Neurology 330 Mount Sinai Dr, Dahlonega, GA 30533-2367 2006-08-09
1639112584 Susan Kaye Blank Psychiatry & Neurology 1846 Old Norcross Rd, Suite 100, Lawrenceville, GA 30044-8801 2006-06-14
1194716282 Ramachandra R Paidi Psychiatry & Neurology 106 Queen St, Suite 1a, Vidalia, GA 30474-4210 2005-10-29
1396389185 Keystone Psychiatric Care LLC Psychiatry & Neurology 11030 Jones Bridge Rd Ste 301, Johns Creek, GA 30022-4560 2019-11-05
1841672789 Joseph Emmanuel Mathias Psychiatry & Neurology 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 2015-06-28
1093067084 Kambiz Aflatoon Do Psychiatry & Neurology 2150 Peachford Rd, Suite A, Atlanta, GA 30338-6520 2012-10-15
Find all providers with the same taxonomy

Competitor

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City VILLA RICA
Zip Code 30180

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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