Individual
SUPORN PONGLORPISIT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1808 SHERMAN DR, PRINCETON, IN 47670-1043
(812) 385-3401
(812) 385-9249
Mailing address
1808 SHERMAN DR, PRINCETON, IN 47670-1043
(812) 385-3401
(812) 385-9249
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01039904A
IN
Other
Enumeration date
12/27/2005
Last updated
07/08/2007
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