Provider Demographics
NPI:1750985263
Name:NKETIA, OPPONG
Entity type:Individual
Prefix:
First Name:OPPONG
Middle Name:
Last Name:NKETIA
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 1:9197 READING RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3348
Mailing Address - Country:US
Mailing Address - Phone:513-733-8550
Mailing Address - Fax:
Practice Address - Street 1:9197 READING RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:OH
Practice Address - Zip Code:45215-3348
Practice Address - Country:US
Practice Address - Phone:513-733-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03439233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist