Individual
DR. PRABHAKORN KITBHOKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
710 PARK PL, MISHAWAKA, IN 46545-3519
(574) 273-6787
(574) 968-7160
Mailing address
PO BOX 5909, PORTLAND, OR 97228-5909
(574) 273-6767
(574) 968-7160
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
01077845A
IN
207RN0300X
Nephrology Physician
Primary
96918
GA
207RN0300X
Nephrology Physician
MD211417
OR
Other
Enumeration date
07/20/2009
Last updated
12/16/2024
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