Individual
BOONFU BOONYASAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 ST. MARYS STREET, LOWER LEVEL, PILOT KNOB, MO 63663
(573) 546-3929
(573) 546-3962
Mailing address
PO BOX 527, PILOT KNOB, MO 63663-0527
(573) 546-3929
(573) 546-3962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33967
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200666303
—
MO
Enumeration date
03/23/2006
Last updated
12/15/2009
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