Individual
DR. BOONKIT PURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 98431-1000
(253) 968-1760
Mailing address
9040 JACKSON AVENUE, TACOMA, WA 98431-0001
(301) 295-1339
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01078922A
IN
207W00000X
Ophthalmology Physician
Primary
MD61576249
WA
208D00000X
General Practice Physician
01078922A
IN
Other
Enumeration date
03/03/2016
Last updated
01/01/2025
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