Basic Information
| Provider Information | |||||||||
| NPI: | 1336323609 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OMORO | ||||||||
| FirstName: | SOPHIA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 BELLEFONTAINE AVE | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458042800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199984575 | ||||||||
| FaxNumber: | 4199984586 | ||||||||
| Practice Location | |||||||||
| Address1: | 1005 BELLEFONTAINE AVE STE 125 | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458042893 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199988244 | ||||||||
| FaxNumber: | 4199988243 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2007 | ||||||||
| LastUpdateDate: | 11/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | MD.201447 | LA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | MD201447 | LA | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 35.129523 | OH | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.