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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366420853 NPPES
Virginia Other C06778 GROUP PTAN

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