Pintavorn, Vanitcha R

Pintavorn, Vanitcha R is an sole proprietor health care provider with primary practice located at 418 Town Park Blvd Suite 1A, Evans GA 30809-3091. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy, which is considered as her primary health care specialty. Pintavorn, Vanitcha R can be contacted via phone (706) 650-1662.

Contact Information

Primary practice address
418 Town Park Blvd Suite 1A Evans GA 30809-3091
Phone: (706) 650-1662
Fax: (706) 854-2131
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 048291 Georgia

Profile Details

NPI number 1215931555
LBN Legal business name Pintavorn, Vanitcha R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Jul 11th, 2008 - about 18 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 1215931555 NPPES
Georgia MEDICAID 000894154D
Georgia MEDICAID G48291

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