Individual
BOONPHIPHOP BOONPHENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
117 N HICKORY AVE STE 200, COOKEVILLE, TN 38501-2424
(931) 646-0880
(866) 834-5618
Mailing address
117 N HICKORY AVE STE 200, COOKEVILLE, TN 38501-2424
(931) 646-0880
(866) 834-5618
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
64918
TN
Other
Enumeration date
07/08/2016
Last updated
09/22/2022
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