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Individual

DR. IRENE A OMOTOSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
112 GOVERNORS SQ STE B, PEACHTREE CITY, GA 30269-4864
(678) 932-8112
(678) 932-8113
Mailing address
112 GOVERNORS SQ STE B, PEACHTREE CITY, GA 30269-4864
(678) 932-8112
(678) 932-8113

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053629
GA
208M00000X
Hospitalist Physician
053629
GA

Other

Enumeration date
08/12/2006
Last updated
07/21/2022
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