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General NPI Number Information
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NPI Number | 1043772445
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Entity Type | Individual
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Provider Name | EVANS COLLINS AMOAH
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Gender | Male
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 250 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1760
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Country | US
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Telephone | 270-781-7178
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Fax | 270-796-5516
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Provider Business Mailing Address
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Address Line | 800 ROSE ST
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City | LEXINGTON
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State | KY
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Zip | 40536-7001
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Country | US
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Telephone | 859-257-7614
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | R6839
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License Number State | KY
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