Individual
SUTHIPONG SOONTRAPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 STATE HIGHWAY 248 STE 200, BRANSON, MO 65616-4186
(417) 336-4112
Mailing address
PO BOX 7411626, CHICAGO, IL 60674-5626
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2016014931
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200042998
—
MO
Enumeration date
06/22/2010
Last updated
04/02/2026
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