Basic Information
Provider Information
NPI: 1144516485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KWAKYE
FirstName: ADONTENG
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE ST RM HX-315
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8593237272
FaxNumber:  
Practice Location
Address1: 800 ROSE ST
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405368905
CountryCode: US
TelephoneNumber: 8593232636
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2011
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XLL33899SCN Allopathic & Osteopathic PhysiciansSurgery 
2085R0202X50268KYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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