Individual
DR. KORNPONG VANTANASIRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
69207
MN
207RG0100X
Gastroenterology Physician
72502
AZ
Other
Enumeration date
05/25/2018
Last updated
09/02/2025
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