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Organization
JYDES FAMILY CLINIC LLC
Active
Organization
JYDES FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAOLAT ABIOLA BABALAKIN M.D. (CEO/OWNER)
(678) 466-7342
Entity
Organization
Contact information
Practice address
4720 PEACHTREE INDUSTRIAL BLVD, SUITE 4101, NORCROSS, GA 30071-5735
(770) 686-3232
(770) 686-3233
Mailing address
5805 STATE BRIDGE RD STE G-106, JOHNS CREEK, GA 30097-8220
(770) 903-4665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G263383
MEDICARE PTAN
GA
Enumeration date
09/01/2010
Last updated
10/09/2025
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