| Doctor Name: | JOSEPH OBUBA |
| NPI Number: | 1043630627 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | RN228348 |
| Business Practice Address: | 2022 Fairburn Rd Suite D Douglasville, GA - 301351062 |
| Business Phone Number: | 7709421044 |
| Business Fax Number: | 7709421699 |
| Mailing Address: | 2022 Fairburn Rd, Suite D DOUGLASVILLE |
| State: | GA |
| Postal Code: | 301351062 |
| Phone Number: | 7709421044 |
| Fax Number: | 7709421699 |
| NPI Enumeration Date: | 04/22/2014 |
| NPI Last Update Date: | 04/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN228348 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |