Individual
BANPOTE POOSUTHASEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
47 W.WEBSTER STREET, SEBREE, KY 42455-0426
(270) 835-7541
Mailing address
PO BOX 426, SEBREE, KY 42455-0426
(270) 835-7541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
24993
KY
208600000X
Surgery Physician
Primary
24993
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049005
ANTHEM BCBS
KY
01
—
198961
BLACK LUNG
—
05
—
64249931
—
KY
Enumeration date
08/30/2006
Last updated
09/11/2025
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