Organization
S. KULKAMTHORN MD, INC.
Active
Parent organization
S. KULKAMTHORN MD, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
S. KULKAMTHORN MD, INC.
Authorized official
MRS. PAMELA EISENBATH (OFFICE MANAGER)
(636) 332-6660
Entity
Organization
Contact information
Practice address
510 W PEARCE BLVD, WENTZVILLE, MO 63385-1343
(636) 332-6660
(636) 332-6660
Mailing address
510 W PEARCE BLVD, WENTZVILLE, MO 63385-1343
(636) 332-6660
(636) 332-6660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35018
MO
208600000X
Surgery Physician
35018
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201098019
—
MO
Enumeration date
08/23/2010
Last updated
08/23/2010
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