# S. KULKAMTHORN MD, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** S. KULKAMTHORN MD, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669788063
- **Legal business name:** S. KULKAMTHORN MD, INC.
- **Authorized official:** MRS. PAMELA EISENBATH (OFFICE MANAGER)
- **Authorized official phone:** (636) 332-6660

## Contact information

- **Practice address:** 510 W PEARCE BLVD, WENTZVILLE, MO 63385-1343
- **Practice address phone:** (636) 332-6660
- **Practice address fax:** (636) 332-6660
- **Mailing address:** 510 W PEARCE BLVD, WENTZVILLE, MO 63385-1343
- **Mailing address phone:** (636) 332-6660
- **Mailing address fax:** (636) 332-6660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 35018 | MO | Yes |
| 208600000X | Surgery Physician | 35018 | MO | — |

## Other

- **Enumeration date:** 08/23/2010
- **Last updated:** 08/23/2010