Osisanya, Victor

Osisanya, Victor is an individual health care provider with primary practice located at 2550 Windy Hill Rd Se Ste 215 Ste 215, Marietta GA 30067-8654. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Osisanya, Victor can be contacted via phone (770) 850-8464.

Contact Information

Primary practice address
2550 Windy Hill Rd Se Ste 215 Ste 215 Marietta GA 30067-8654
Phone: (770) 850-8464
Fax: (770) 850-9727
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 71689 Georgia
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 71689 Georgia
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 71689 Georgia

Profile Details

NPI number 1679884753
LBN Legal business name Osisanya, Victor
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2010
Last updated Feb 19th, 2015 - about 9 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 1679884753 NPPES
Georgia MEDICAID 003153374F
Georgia MEDICAID 003153374B
Georgia MEDICAID 003153374D
Georgia MEDICAID 003153374E
Georgia MEDICAID 003153374G
Georgia MEDICAID 003153374C

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