Organization
UNIVERSAL LUNG ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUFUNSHO OLADIPO BANKOLE M.D (MANAGER/OWNER)
(806) 290-0485
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1285, ATLANTA, GA 30308-2208
(404) 856-3216
Mailing address
550 PEACHTREE ST NE, SUITE 1285, ATLANTA, GA 30308-2208
(404) 856-3216
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
58391
GA
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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