Izeiyamu, Osayande Stephen
Izeiyamu, Osayande Stephen is an sole proprietor health care provider with primary practice located at 194 Sw Wall Ter , Lake City FL 32025-5086. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Izeiyamu, Osayande Stephen can be contacted via phone (386) 719-9227.Contact Information
Primary practice address
194 Sw Wall Ter
Lake City FL 32025-5086
Phone: (386) 719-9227
Fax: (386) 719-9488
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | BP10043366 | Texas |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ACN634 | Florida |
Profile Details
| NPI number | 1255698619 |
|---|---|
| LBN Legal business name | Izeiyamu, Osayande Stephen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 23rd, 2012 |
| Last updated | Jan 20th, 2016 - about 8 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 | 1255698619 | NPPES |
| Florida | MEDICAID | 014632400 |
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