Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Olufisayo Tayo Otusanya, MBCHB

Individual provider Internal Medicine Physician · NPI 1336552785

Dr. Olufisayo Tayo Otusanya, MBCHB is a Pulmonary Disease in Stockbridge, Georgia. Qualified in 2010, 16 years ago. Practices with Piedmont Providers LLC, a 518-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia and Louisiana.

Years since qualifying
16
Licensed in
GA, LA
In the registry since
2014
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

135 N Park Pl Ste 200
Stockbridge, GA 30281-7209
Phone: (678) 289-7960
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1400 Pelham Pkwy S, Bronx, NY 10461-1138 — (718) 918-5640

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 84957 (GA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 305582 (LA)

Record details

NPI number1336552785
Entity typeIndividual (Type 1)
GenderMale
Credentials MBCHB
Sole proprietorNo
NPI enumeratedJune 3, 2014
Last updated in NPPESJuly 22, 2020
Certification dateJuly 22, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPULMONARY DISEASE
Also practisesCRITICAL CARE (INTENSIVISTS)
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Piedmont Providers Llc — 518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Stockbridge