Individual
VANCHAI VONGCHANYAKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3462 HOSPITAL RD, HEALDTON, OK 73438-6124
(580) 229-0701
(580) 229-1454
Mailing address
530 N MONTE VISTA ST, SUITE A, ADA, OK 74820-4675
(580) 436-7101
(580) 436-4447
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA847
OK
Other
Enumeration date
05/12/2006
Last updated
11/20/2014
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