Organization
SOUTH GEORGIA UROLOGY CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REX O AJAYI M.D. (PHYSICIAN)
(229) 435-0832
Entity
Organization
Contact information
Practice address
803 N JACKSON ST, ALBANY, GA 31701
(229) 435-0832
(229) 435-2857
Mailing address
P.O. BOX 72108, ALBANY, GA 31708
(229) 435-0832
(229) 435-2857
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00279518A
—
GA
01
—
DG1080
RAILROAD MEDICARE
GA
Enumeration date
05/04/2007
Last updated
12/20/2007
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