Drg Fayette, Pllc
NPI #1649556721 in Fayette, Mississippi
Provider Information
- NPI Number
- 1649556721
- Entity Type
- Organization
- Organization Name
- Drg Fayette, Pllc
- Primary Specialty
- Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
- Enumeration Date
- Nov 2, 2011
- Last Updated
- Nov 14, 2011
Practice Location
- Address
- 1005 MAIN STREET
- City
- Fayette
- State
- Mississippi
- ZIP Code
- 39069
- Phone
- (601) 488-1070
Authorized Official
- Name
- DR. TUNDE OLUTADE, M.D.
- Title
- OWNER
- Phone
- (601) 899-3340
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment |
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