Individual
KRIENGKRAI KITIPHONGSPATTANA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 HOSPITAL DR, LOGAN, WV 25601-0656
(304) 831-1254
(304) 831-1679
Mailing address
20 HOSPITAL DR, LOGAN, WV 25601
(304) 831-1254
(304) 831-1679
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
12458
WV
2086S0129X
Vascular Surgery Physician
12458
WV
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
12458
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128282000
—
WV
Enumeration date
04/14/2006
Last updated
09/11/2025
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