Tanphaichitr, Kongsak

Tanphaichitr, Kongsak is an sole proprietor health care provider with primary practice located at 11115 New Halls Ferry Rd Suite 102, Florissant MO 63033-7613. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Rheumatology is his primary health care specialty. Tanphaichitr, Kongsak can be contacted via phone (314) 839-4339.

Contact Information

Primary practice address
11115 New Halls Ferry Rd Suite 102 Florissant MO 63033-7613
Phone: (314) 839-4339
Fax: (314) 839-0011
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207RA0201X 35104 Missouri
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 35104 Missouri

Profile Details

NPI number 1942362777
LBN Legal business name Tanphaichitr, Kongsak
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2006
Last updated Aug 3rd, 2012 - about 12 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 1942362777 NPPES
Missouri MEDICAID 200861813

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