Individual
KINGSLEY E IYAMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 LAKE PARK DR SE, 218, SMYRNA, GA 30080-7647
(404) 213-8526
(770) 438-1125
Mailing address
1850 LAKE PARK DR SE, 218, SMYRNA, GA 30080-7647
(404) 213-8526
(770) 438-1125
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
044493
GA
2084P0805X
Geriatric Psychiatry Physician
044493
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000899808B
—
GA
Enumeration date
10/19/2006
Last updated
10/19/2011
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