Individual
OUEN PONGDEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PSC INC
Contact information
Practice address
3600 W. CUMBERLAND AVE, MIDDLESBORO, KY 40965-2614
(606) 242-1428
(606) 248-1518
Mailing address
PO BOX 177, MIDDLESBORO, KY 40965-0177
(606) 248-1320
(606) 248-1518
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17332
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64173321
—
KY
Enumeration date
06/21/2006
Last updated
01/31/2011
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