Individual provider · NPI-1

Dr. Omoniyi Yakubu Adebisi, MD, DABFP

Family Medicine · Memphis, TN

NPI number1689622128
StatusActive
Last updated in NPPESOct 1, 2010

Details

NPI
1689622128
Entity type
Individual (NPI-1)
Name
Dr. Omoniyi Yakubu Adebisi
Credential
MD, DABFP
Sex
Male
Sole proprietor
No
Enumeration date
May 5, 2006
Last updated
Oct 1, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine38880TNYes
207VX0000X Obstetrics & Gynecology, Obstetrics38880TN

Practice location

3030 Covington Pike
Suite 100
Memphis, TN 38128-5048

Phone 901-383-8889 · Fax 901-383-2245

Mailing address

Po Box 215
Tallapoosa, GA 30176-0215

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