Individual
ISSARA AYUTHIA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 AVENUE A, DODGE CITY, KS 67801-6508
(620) 225-8437
Mailing address
PO BOX 1331, DODGE CITY, KS 67801-1331
(316) 685-6236
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
04-17419
KS
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
04-17419
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002902
BCBS
KS
Enumeration date
03/09/2006
Last updated
09/11/2025
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