Individual
KANTIMA PHISITKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1007
(319) 356-3446
(319) 356-2999
Mailing address
357 W TOWER RD, DAKOTA DUNES, SD 57049-5018
(712) 255-7746
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
07/03/2019
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