Provider Demographics
NPI:1093013567
Name:OYADIRAN, JOHN OLAGBAMI
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:OLAGBAMI
Last Name:OYADIRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 GLENORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-1004
Mailing Address - Country:US
Mailing Address - Phone:513-761-0428
Mailing Address - Fax:
Practice Address - Street 1:7910 GLENORCHARD DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-1004
Practice Address - Country:US
Practice Address - Phone:513-761-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 132889-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse