Provider Demographics
NPI:1073779435
Name:SARPONG, YAW D (MD)
Entity type:Individual
Prefix:
First Name:YAW
Middle Name:D
Last Name:SARPONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N EAST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1753
Mailing Address - Country:US
Mailing Address - Phone:517-205-1591
Mailing Address - Fax:517-205-1713
Practice Address - Street 1:205 N EAST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1753
Practice Address - Country:US
Practice Address - Phone:517-205-1591
Practice Address - Fax:517-205-1713
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-42333207T00000X
ORMD187909207T00000X
WAMD60267049207T00000X
MI4301503557207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery