Individual
DR. UKORN SRIVATANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
237737-1
NY
207RG0100X
Gastroenterology Physician
Primary
MD068303L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018809680001
—
PA
05
—
02238397
—
NY
01
—
10016154
RR MEDICARE GROUP
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039897
PA MEDICARE GROUP
PA
01
—
P00318222
RAILROAD PIN
NY
Enumeration date
02/20/2006
Last updated
02/26/2021
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