Provider Demographics
NPI:1346123544
Name:ADEOGUN, TAMILORE
Entity type:Individual
Prefix:
First Name:TAMILORE
Middle Name:
Last Name:ADEOGUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GILMER CT
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-9555
Mailing Address - Country:US
Mailing Address - Phone:404-514-2315
Mailing Address - Fax:
Practice Address - Street 1:17 GILMER CT
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-9555
Practice Address - Country:US
Practice Address - Phone:404-514-2315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program