Individual
KUMPOL DENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44 KILMARTIN CT, VALPARAISO, IN 46385-9304
(219) 688-3950
Mailing address
44 KILMARTIN CT, VALPARAISO, IN 46385-9304
(219) 688-3950
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01071776A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100142380
—
IN
Enumeration date
11/05/2012
Last updated
06/07/2016
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