Individual
NORRAPOL WATTANASUWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1203 JEFFERSON ST, LAUREL, MS 39440-4354
(601) 649-2863
(601) 649-9479
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
(601) 399-6184
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
18611
MS
207UN0901X
Nuclear Cardiology Physician
18611
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07708391
—
MS
01
—
731-05467
BLUE CROSS BLUE SHILED OF AL
AL
01
—
P00220397
RR MEDICARE
—
Enumeration date
06/17/2006
Last updated
07/30/2020
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