Individual
DAVIS P VIPRAKASIT
Active
Individual
DAVIS P VIPRAKASIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036116617
IL
208800000X
Urology Physician
Primary
201100924
NC
208800000X
Urology Physician
44906
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036116617
ILLINOIS LICENSE
IL
01
—
201100924
LICENSE
NC
01
—
44906
TN LICENSE
TN
Enumeration date
08/05/2008
Last updated
04/01/2021
Update your record
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