Provider Demographics
NPI:1417255803
Name:OYEWALE, ISAAC AYO
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:AYO
Last Name:OYEWALE
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 1:5018 GRAFTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237
Mailing Address - Country:US
Mailing Address - Phone:513-910-7983
Mailing Address - Fax:
Practice Address - Street 1:5018 GRAFTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-6030
Practice Address - Country:US
Practice Address - Phone:513-910-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN129409IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse