Fabayo, Adesola Omotayo

Fabayo, Adesola Omotayo is an sole proprietor health care provider with primary practice located at 610 S 8Th St Suite F, Griffin GA 30224-4201. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Fabayo, Adesola Omotayo can be contacted via phone (770) 228-8550.

Contact Information

Primary practice address
610 S 8Th St Suite F Griffin GA 30224-4201
Phone: (770) 228-8550
Fax: (770) 228-1478
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 45782 Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 045782 Georgia
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 045782 Georgia

Profile Details

NPI number 1265482285
LBN Legal business name Fabayo, Adesola Omotayo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2006
Last updated Jul 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265482285 NPPES
Georgia MEDICAID 000870669B
Georgia MEDICAID 00870669A

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