Individual
PAKPOOM TANTRACHOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 NW EXPRESSWAY STE 200, OKLAHOMA CITY, OK 73112-4491
(405) 713-9900
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 552-0155
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
38246
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2014
Last updated
08/23/2021
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