Healthcare Provider Details

I. General information

NPI: 1245147313
Provider Name (Legal Business Name): SAMUEL OPPONG AMAKYE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 BECKER DR
LAWRENCE KS
66047-1620
US

IV. Provider business mailing address

15101 LAMAR AVE APT C
OVERLAND PARK KS
66223-3171
US

V. Phone/Fax

Practice location:
  • Phone: 913-548-1531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number3-122658
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: