Organization
WATERFALLS MEDICAL PRACTICE, P.C
Active
Organization
WATERFALLS MEDICAL PRACTICE, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE AYOYINKA OMOTOSO MD (MEDICAL DIRECTOR)
(678) 932-8112
Entity
Organization
Contact information
Practice address
112 GOVERNORS SQ STE B, PEACHTREE CITY, GA 30269-4864
(678) 932-8112
(678) 932-8113
Mailing address
1202 TOLMOUNT CT, PEACHTREE CITY, GA 30269-3348
(678) 932-8112
(678) 932-8113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053629
GA
Other
Enumeration date
06/05/2017
Last updated
06/16/2020
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