Individual
DR. OLUKUNLE SAMUEL OMOLAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 HEMLOCK ST # 69, MACON, GA 31201-2102
(478) 301-5824
Mailing address
764 PINE ST, MACON, GA 31201-2107
(478) 633-1721
(478) 633-2316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16586
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2024
Last updated
06/17/2024
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