Provider Demographics
NPI:1285449868
Name:OPPONG-BAIDOO, JOE
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:
Last Name:OPPONG-BAIDOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5256 ANSBACH DR
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-3504
Mailing Address - Country:US
Mailing Address - Phone:614-256-2334
Mailing Address - Fax:
Practice Address - Street 1:5256 ANSBACH DR
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-3504
Practice Address - Country:US
Practice Address - Phone:614-256-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2024095281363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health