Hompluem, Uraiwan Tana

Hompluem, Uraiwan Tana is an individual health care provider with primary practice located at 2 Terminal Dr Suite 8, East Alton IL 62024-2268. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Hompluem, Uraiwan Tana can be contacted via phone (618) 259-1419.

Contact Information

Primary practice address
2 Terminal Dr Suite 8 East Alton IL 62024-2268
Fax: (618) 259-1502
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036067508 Illinois

Profile Details

NPI number 1477619278
LBN Legal business name Hompluem, Uraiwan Tana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Apr 25th, 2016 - about 8 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 1477619278 NPPES
Illinois MEDICAID 036067508

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