Doctor Name: | SUNAN VONGKASEMSIRI |
NPI Number: | 1275578387 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD0000014904 |
Business Practice Address: | 1850 Old Knoxville Rd Tazewell, TN - 378793625 |
Business Phone Number: | 4266264211 |
Business Fax Number: | 6062481518 |
Mailing Address: | Po Box 596, TAZEWELL |
State: | TN |
Postal Code: | 378790596 |
Phone Number: | 6062481320 |
Fax Number: | 6062481518 |
NPI Enumeration Date: | 06/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | MD0000014904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |