Phommachanh, Viengsouk
Phommachanh, Viengsouk is an individual health care provider with primary practice located at 2401 University Pkwy Ste 102 , Sarasota FL 34243-2894. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Phommachanh, Viengsouk can be contacted via phone (941) 355-2767.Contact Information
Primary practice address
2401 University Pkwy Ste 102
Sarasota FL 34243-2894
Phone: (941) 355-2767
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | ME98812 | Florida |
Profile Details
| NPI number | 1235331141 |
|---|---|
| LBN Legal business name | Phommachanh, Viengsouk |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 3rd, 2007 |
| Last updated | Oct 28th, 2021 - about 3 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 | 1235331141 | NPPES |
| Florida | MEDICAID | 002451300 | |
| Florida | Other | DI326Z |
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