Individual
KANTIMA PHISITKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3500
(712) 279-3640
Mailing address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3500
(712) 279-3640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38776
IA
207RN0300X
Nephrology Physician
Primary
38776
IA
390200000X
Student in an Organized Health Care Education/Training Program
BP1-0024170
TX
Other
Enumeration date
08/15/2007
Last updated
06/16/2026
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