Individual
VICTOR OSISANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2550 WINDY HILL RD SE STE 215, STE 215, MARIETTA, GA 30067-8654
(770) 850-8464
(770) 850-9727
Mailing address
2550 WINDY HILL RD SE STE 215, STE 215, MARIETTA, GA 30067-8654
(770) 850-8464
(770) 850-9727
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
71689
GA
208VP0000X
Pain Medicine Physician
Primary
71689
GA
208VP0014X
Interventional Pain Medicine Physician
71689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003153374B
—
GA
05
—
003153374C
—
GA
05
—
003153374D
—
GA
05
—
003153374E
—
GA
05
—
003153374F
—
GA
05
—
003153374G
—
GA
Enumeration date
06/23/2010
Last updated
02/19/2015
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