Individual
MRS. SUTTIWARA VIPRAKASIT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1995 HWY 51 SOUTH, BAPTIST MEMORIAL HOSPITAL TIPTON, COVINGTON, TN 38019
(901) 476-2621
Mailing address
PO BOX 761, COVINGTON, TN 38019
(901) 476-1135
(901) 476-1136
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD11009
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3384839
—
TN
Enumeration date
11/17/2005
Last updated
07/08/2007
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