Provider Demographics
NPI:1639521420
Name:TWUM-AMPOFO, JEFFREY KOFI (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:KOFI
Last Name:TWUM-AMPOFO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 COUNTRY CLUB DR STE 100
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9069
Mailing Address - Country:US
Mailing Address - Phone:770-474-5281
Mailing Address - Fax:770-389-8674
Practice Address - Street 1:290 COUNTRY CLUB DR STE 100
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9069
Practice Address - Country:US
Practice Address - Phone:770-474-5281
Practice Address - Fax:770-389-8674
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA88810208800000X
MA266969208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes208800000XAllopathic & Osteopathic PhysiciansUrology