Individual
MR. NONTAPOTH X WONGKITTIARKORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-7373
Mailing address
2120 MARDALE CIR, JOPLIN, MO 64804-7878
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-19361
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2022
Last updated
05/15/2025
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