Provider Demographics
NPI:1053804096
Name:ONIBONOJE, OLUSEGUN KAYODE (DO)
Entity type:Individual
Prefix:
First Name:OLUSEGUN
Middle Name:KAYODE
Last Name:ONIBONOJE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 W SHERMAN AVE # 93
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7059
Mailing Address - Country:US
Mailing Address - Phone:856-641-8000
Mailing Address - Fax:
Practice Address - Street 1:6001 SW 6TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1004
Practice Address - Country:US
Practice Address - Phone:785-233-7491
Practice Address - Fax:785-233-3187
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-49713207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery