| Doctor Name: | KUMPOL DENNISON |
| NPI Number: | 1275887770 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01071776A |
| Business Practice Address: | 44 Kilmartin Ct Valparaiso, IN - 463859304 |
| Business Phone Number: | 2196883950 |
| Business Fax Number: | |
| Mailing Address: | 44 Kilmartin Ct, VALPARAISO |
| State: | IN |
| Postal Code: | 463859304 |
| Phone Number: | 2196883950 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2012 |
| NPI Last Update Date: | 06/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01071776A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |