Individual
SUPAT THAMMASITBOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1430 TULANE AVE, SL-9, NEW ORLEANS, LA 70112-2632
(504) 988-2250
Mailing address
1430 TULANE AVE, SL-9, NEW ORLEANS, LA 70112-2632
(504) 988-2250
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
13682R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1424871
—
LA
Enumeration date
08/18/2006
Last updated
07/08/2007
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