Iyamu, Kingsley E
Iyamu, Kingsley E is an individual health care provider with primary practice located at 1850 Lake Park Dr Se 218, Smyrna GA 30080-7647. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Iyamu, Kingsley E can be contacted via phone (404) 213-8526.Contact Information
Primary practice address
1850 Lake Park Dr Se 218
Smyrna GA 30080-7647
Phone: (404) 213-8526
Fax: (770) 438-1125
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 044493 | Georgia |
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | 044493 | Georgia |
Profile Details
| NPI number | 1275615171 |
|---|---|
| LBN Legal business name | Iyamu, Kingsley E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 19th, 2006 |
| Last updated | Oct 19th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275615171 | NPPES |
| Georgia | MEDICAID | 000899808B |
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