MEDICARE: MR. FELIX AMEYAW OPPONG LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN-133148	OH

General Provider Information

NPI Number	:	1710121462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FELIX AMEYAW OPPONG LPN

Provider Business Mailing Address
First Line	:	2896 POOLSIDE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-4663
Country	:	US
Telephone Number	:	614-476-6629
Fax Number	:

Provider Business Practice Location Address
First Line	:	2896 POOLSIDE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-4663
Country	:	US
Telephone Number	:	614-476-6629
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	07/24/2023

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