# MEDIC ONE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255690475
- **Authorized official:** ADESUPO OSHIYOYE (TREASURER)
- **Authorized official phone:** (770) 894-3167

## Contact information

- **Practice address:** 2621 SANDY PLAINS RD, SUITE 304, MARIETTA, GA 30066-4267
- **Practice address phone:** (770) 894-3167
- **Practice address fax:** (770) 575-0879
- **Mailing address:** PO BOX 670508, MARIETTA, GA 30066-0126
- **Mailing address phone:** (770) 894-3167
- **Mailing address fax:** (770) 575-0879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | 51736 | GA | Yes |

## Other

- **Enumeration date:** 05/08/2012
- **Last updated:** 05/08/2012