Provider Demographics
NPI:1750944112
Name:IRABOR, OMORUYI C (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:OMORUYI
Middle Name:C
Last Name:IRABOR
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:OMORUYI
Other - Middle Name:CREDIT
Other - Last Name:IRABOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67402-0256
Mailing Address - Country:US
Mailing Address - Phone:785-823-0633
Mailing Address - Fax:785-823-0658
Practice Address - Street 1:1401 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2570
Practice Address - Country:US
Practice Address - Phone:620-342-1117
Practice Address - Fax:855-774-5285
Is Sole Proprietor?:No
Enumeration Date:2019-04-20
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-494972085R0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program