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Individual

SUTHON CHATKUPT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1700 RAINBOW BLVD, EXCELSIOR SPRINGS, MO 64024-1182
(816) 629-2743
(816) 629-2708
Mailing address
1700 RAINBOW BLVD, EXCELSIOR SPRINGS, MO 64024-1182
(816) 629-2743
(816) 629-2708

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33979
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00297056
BLUE CROSS BLUE SHIELD
01
021577062
RAILROAD MEDICARE
01
10001311700
COMMUNITY HEALTH
01
100240
FIRST GUARD
01
10270
BUNN
MO
01
1042753
ECFMG
01
17080111
UNITED HEALTH CARE
05
200236933
MO
01
301800
FAMILY HEALTH PARTNERS
01
3127327007
CIGNA
01
33825
HEALTHCARE USA
01
36553
FIRST HEALTH
01
4035241
AETNA
01
431726195
TAX ID
01
709912
BLUE CROSS BLUE SHIELD
KS
Enumeration date
12/01/2005
Last updated
03/07/2023
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