Individual
SUNGNAM JOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1510 N STOCKTON HILL RD, KINGMAN, AZ 86401-5173
(928) 753-1177
(928) 718-4501
Mailing address
1510 N STOCKTON HILL RD, KINGMAN, AZ 86401-5173
(928) 753-1177
(928) 718-4501
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24593
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24593
LICENSE
AZ
05
—
363151
—
AZ
Enumeration date
09/15/2005
Last updated
04/17/2026
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