P Praxis·MD
● Active Type 1 · Individual

DR. Olaniyi Olabode Osofisan, M.D.

Internal Medicine·Braselton, GA· NPI 1447333554 · Enumerated 2006 · 19 years on NPI
Osofisan is 1 of 9 internal medicine providers in Braselton and 1 of 952 in Georgia.
NPI age
19 years
Enumerated 2006-10-23
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
GA, MT
2 states
Status
Active
No deactivations on record
Last NPPES update
2025-04-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 952 active internal medicine providers in Georgia.

NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 82% — 17% of peers are multi-state
Subspecialties
0
40% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-10Enumerated in NPPES
2006 2026

Where they practice

Practice location
1404 River Pl Ste 501
Braselton, GA 305175600
📞 7708487160
Mailing address
Po Box 742616
Atlanta, GA 303742616
📞 7702198420

Additional practice locations

2 secondary locations on file with NPPES.

Location 2
3459 Acworth Due West Rd Nw, Suite 559
Acworth, GA 301015819
📞 7705297922fax 7705297931
Location 3
937 Highland Blvd
Bozeman, MT 597156909
📞 4064145000

Specialties

  • Internal Medicine Primary
    An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
    GA license #053797MT license #148664 taxonomy 207RC0000X

Identifiers

TypeValueNotes
05 (GA) 173191749A
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.

Practice context

Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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