Organization
MANOSH VONGVISES, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOSH VONGVISES M.D. (PHYSICIAN)
(606) 432-3277
Entity
Organization
Contact information
Practice address
419 TOWN MOUNTAIN RD, SUITE 104, PIKEVILLE, KY 41501-1631
(606) 432-3277
(606) 432-6771
Mailing address
419 TOWN MOUNTAIN RD, SUITE 104, PIKEVILLE, KY 41501-1631
(606) 432-3277
(606) 432-6771
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20681
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64206816
—
KY
Enumeration date
06/28/2010
Last updated
06/28/2010
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