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Organization

OMNI CLINIC SYLCAUGA

Active
Parent organization
OMNI CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
OMNI CLINIC
Authorized official
ADE LADIPO (DR)
(256) 236-3031
Entity
Organization

Contact information

Practice address
303 N MAIN AVE, SYLACAUGA, AL 35150-2629
(256) 245-9140
Mailing address
PO BOX 1308, SYLACAUGA, AL 35150-1308

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1417055179
ABAYOMI SANUSI MD,NPI NUM
AL
01
1972601607
ADETOKUNBO LADIPO MD. NPI
AL
Enumeration date
05/24/2007
Last updated
07/24/2007
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