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Individual

DR. OSAWARU JUDE OMORUYI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2202 BUECHEL AVE STE 103, LOUISVILLE, KY 40218-2672
(502) 456-0494
(502) 456-0496
Mailing address
2202 BUECHEL AVE, STE 105, LOUISVILLE, KY 40218-2672
(502) 456-0494
(502) 456-0496

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35.088666
OH
207Q00000X
Family Medicine Physician
Primary
42023
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01066757A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2009500930
IN
05
7100072730
KY
Enumeration date
04/18/2007
Last updated
04/14/2026
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