OLUJIMI AYODELE ADEFISAN (NPI# 1790947216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790947216 |
| Entity Type | Individual |
| Full Name | OLUJIMI AYODELE ADEFISAN |
| Credential | M.D |
| Practice Address |
1003 Mary Street Waycross GA 31503 |
| Practice Telephone | 9124497100 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2012-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
063623 | GA | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MT 185915 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003121311A | 05 |
| Street Address |
1003 MARY STREET |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073650115 | Unison Behavioral Health | Community/Behavioral Health | 1003 Mary Street, Waycross, GA 31503 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770855868 | Bertha Richardsaon | Community/Behavioral Health | 1614 Carswell Ave, Waycross, GA 31503 | 2012-02-03 |
| 1134365893 | Carla Pye Winn | Nurse Practitioner | 1003 Mary St, Waycross, GA 31503 | 2008-12-31 |
| 1801051297 | Unison Behavioral Health | Substance Abuse Rehabilitation Facility | 3455 Harris Road, Waycross, GA 31503 | 2008-07-24 |
| 1588701635 | Unison Behavioral Health | Community/Behavioral Health | 2033 Bell Street, Waycross, GA 31503 | 2007-01-30 |
| 1801933957 | Unison Behavioral Health | Day Training, Developmentally Disabled Services | 3201 Harris Road, Waycross, GA 31503 | 2007-01-30 |
| 1902943046 | Unison Behavioral Health | Community/Behavioral Health | 310 Williams Street, Waycross, GA 31503 | 2007-01-30 |
| 1285770578 | Unison Behavioral Health | Community/Behavioral Health | 305 N Nicholls Street, Waycross, GA 31503 | 2007-01-30 |
| 1538223672 | Diversified Resources, Inc. | Case Manager/Care Coordinator | 147 Knight Ave Cir, Waycross, GA 31503 | 2006-12-21 |
| 1669578167 | James Gregory Morris | Dentist | 2458 Memorial Drive, Waycross, GA 31503 | 2006-09-15 |
| 1134608367 | Latoya Lasha Woodard | Counselor | 1007 Mary Street, Waycross, GA 31503 | 2018-08-08 |
| Find all providers in zip 31503 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205468840 | Angela Leigh Eubanks | Psychiatry & Neurology | 11 S Winston St, Reynolds, GA 31076-3200 | 2020-02-11 |
| 1265064364 | Haven Psychiatry, LLC | Psychiatry & Neurology | 5871 Glenridge Dr Ste 220, Atlanta, GA 30328-5305 | 2020-02-06 |
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1093249393 | Healing for All LLC | Psychiatry & Neurology | 3307 Sir Henry St, East Point, GA 30344-5831 | 2017-04-13 |
| 1699216416 | Abva, Inc | Psychiatry & Neurology | 4565 Rockmart Rd Se, Unit 1261, Silver Creek, GA 30173-2442 | 2017-03-13 |
| 1225436017 | Aatma Seva Health Inc | Psychiatry & Neurology | 523 Dixie St Ste 3, Carrollton, GA 30117-3870 | 2014-12-11 |
| 1619309309 | Howel William Slaughter Jr. | Psychiatry & Neurology | 40 Abington Ct Nw, Atlanta, GA 30327-1352 | 2013-08-05 |
| 1427493568 | Susan Kirsch | Psychiatry & Neurology | 7000 Peachtree Dunwoody Rd Bldg 16, Atlanta, GA 30328-1655 | 2013-05-02 |
| 1023362852 | Rivertown Psychiatry, PC | Psychiatry & Neurology | 1520 22nd Street, Columbus, GA 31901-1632 | 2012-10-31 |
| 1548550429 | Bene' Mental Wellness | Psychiatry & Neurology | 1835 Savoy Dr Ste 101, Atlanta, GA 30341-1073 | 2011-04-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.