Provider Demographics
NPI:1114798808
Name:OPPONG, KOBE
Entity Type:Individual
Prefix:
First Name:KOBE
Middle Name:
Last Name:OPPONG
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 1:3907 HIGGINS DR
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-5512
Mailing Address - Country:US
Mailing Address - Phone:234-281-9898
Mailing Address - Fax:
Practice Address - Street 1:3907 HIGGINS DR
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5512
Practice Address - Country:US
Practice Address - Phone:234-281-9898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide