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General NPI Number Information
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NPI Number | 1336323609
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Entity Type | Individual
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Provider Name | SOPHIA A. OMORO MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1005 BELLEFONTAINE AVE STE 125
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City | LIMA
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State | OH
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Zip | 45804-2893
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Country | US
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Telephone | 419-998-8244
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Fax | 419-998-8243
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Provider Business Mailing Address
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Address Line | 1001 BELLEFONTAINE AVE
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City | LIMA
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State | OH
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Zip | 45804-2800
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Country | US
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Telephone | 419-998-4575
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Fax | 419-998-4586
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD.201447
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD201447
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 35.129523
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License Number State | OH
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