Provider Demographics
NPI:1871564674
Name:DOYIN OGUNBI M.D. L.L.C.
Entity type:Organization
Organization Name:DOYIN OGUNBI M.D. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-288-1916
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-288-1916
Mailing Address - Fax:334-284-1826
Practice Address - Street 1:1722 PINE ST
Practice Address - Street 2:SUITE 1005
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1103
Practice Address - Country:US
Practice Address - Phone:334-288-1916
Practice Address - Fax:334-284-1826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15695207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-18247Medicare ID - Type Unspecified
ALF00321Medicare UPIN