Gbadebo, Olufowobi

Gbadebo, Olufowobi is an individual health care provider with primary practice located at 116 Hill Pond Ln , Statesboro GA 30458-0872. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Gbadebo, Olufowobi can be contacted via phone (912) 489-1629.

Contact Information

Primary practice address
116 Hill Pond Ln Statesboro GA 30458-0872
Phone: (912) 489-1629
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 46201 Wisconsin
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 054096 Georgia
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 054096 Georgia

Profile Details

NPI number 1205924289
LBN Legal business name Gbadebo, Olufowobi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Jul 22nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205924289 NPPES
Wisconsin MEDICAID 32497000

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