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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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