Edmonson, Supakunya
Edmonson, Supakunya is an individual health care provider with primary practice located at Uss Enterprise Medical Dept, Norfolk VA 23551-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Edmonson, Supakunya can be contacted via phone (757) 444-8632.Contact Information
Primary practice address
Uss Enterprise Medical Dept
Norfolk VA 23551-0001
Phone: (757) 444-8632
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS9620 | Florida |
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 0102201767 | Virginia |
Profile Details
NPI number | 1366420853 |
---|---|
LBN Legal business name | Edmonson, Supakunya |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 4th, 2006 |
Last updated | May 18th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1366420853 | NPPES |
Virginia | Other | C06778 | GROUP PTAN |
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