Individual
DR. PHILLIP O AJAYI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
455 S MAIN ST STE 101, HINESVILLE, GA 31313-4354
(912) 876-6868
(912) 876-6566
Mailing address
455 S MAIN ST, STE 103, HINESVILLE, GA 31313-4354
(912) 876-6868
(912) 876-6566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
49871
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039155A
—
GA
Enumeration date
04/27/2010
Last updated
05/25/2021
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