Osayande Stephen Izeiyamu (NPI# 1255698619, PAC ID# 9739409483) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1255698619 |
| PAC ID by PECOS | 9739409483 |
| Professional Enrollment ID | I20150520000378 |
| Full Name | Osayande Stephen Izeiyamu |
| Organization Legal Name | ORIGINS FAMILY MEDICAL AND WEIGHT LOSS CLINIC INC |
| Address |
194 Sw Wall Ter Lake City FL 32025-5086 |
| Phone Number | 3867199227 |
| Gender | M |
| Graduation Year | 2005 |
| Primary Specialty | GENERAL PRACTICE |
| Group Practice PAC ID | 4688808520 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100102 | SHANDS LAKE SHORE REGIONAL MEDICAL CENTER |
| 100156 | LAKE CITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 194 Sw Wall Ter, Lake City, FL 32025-5086 | 3867199227 | ORIGINS FAMILY MEDICAL AND WEIGHT LOSS CLINIC INC |
| Organization Legal Name | ORIGINS FAMILY MEDICAL AND WEIGHT LOSS CLINIC INC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rodney L Scyphers | Nurse Practitioner | Origins Family Medical and Weight Loss Clinic Inc | 194 Sw Wall Ter, Lake City, FL 32025-5086 |
| Street Address |
194 SW WALL TER |
| City | LAKE CITY |
| State | FL |
| Zip | 32025-5086 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rodney L Scyphers | Nurse Practitioner | Origins Family Medical and Weight Loss Clinic Inc | 194 Sw Wall Ter, Lake City, FL 32025-5086 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly C Herring | Clinical Social Worker | 871 Sw State Rd, Suite 47, Lake City, FL 32025-0433 | |
| Charles M Varghese | Cardiovascular Disease (cardiology) | 782 Sw Sisters Welcome Rd, Lake City, FL 32025-0442 | |
| Thomas J Salvucci | Cardiovascular Disease (cardiology) | Lake Shore Hma Medical Group LLC | 755 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Vijay M. Patel | Hematology/oncology | Florida Cancer Specialists and Research Institute, LLC | 495 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Donald Brent Hayden | General Practice | 733 Sw State Rd, Suite 47, Lake City, FL 32025-0453 | |
| Chi Lai | Cardiovascular Disease (cardiology) | Lake Shore Hma Medical Group LLC | 755 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Edwin Gonzalez Navedo | General Surgery | Lake Shore Hma Medical Group LLC | 755 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Stephanie K Finnell | Nurse Practitioner | Lake Shore Hma Medical Group LLC | 755 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Eric Marquez | Obstetrics/gynecology | Lake Shore Hma Medical Group LLC | 755 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Shelley Rose Perry | Nurse Practitioner | Lake Shore Hma Medical Group LLC | 755 Sw State Rd, Suite 47, Lake City, FL 32025-0453 |
| Find all physicians in zip 32025 | |||
| City | LAKE CITY |
| Zip Code | 32025 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | LAKE CITY + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Osayande Stephen Izeiyamu.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.