Healthcare Provider Details

I. General information

NPI: 1669449815
Provider Name (Legal Business Name): KOFI AMOAKO-ABABIO MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 W IRON AVE SUITE A
SALINA KS
67401-2600
US

IV. Provider business mailing address

PO BOX 3362
SALINA KS
67402-3362
US

V. Phone/Fax

Practice location:
  • Phone: 785-309-0355
  • Fax: 785-309-0184
Mailing address:
  • Phone: 785-309-0355
  • Fax: 785-309-0184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0428506
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: