Wattanakit, Keattiyoat

Wattanakit, Keattiyoat is an individual health care provider with primary practice located at 5405 N Knoxville Ave , Peoria IL 61614. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wattanakit, Keattiyoat can be contacted via phone (309) 691-4410.

Contact Information

Primary practice address
5405 N Knoxville Ave Peoria IL 61614
Phone: (309) 691-4410
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 42286 Minnesota
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036126173 Illinois

Profile Details

NPI number 1407821077
LBN Legal business name Wattanakit, Keattiyoat
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Sep 27th, 2010 - about 15 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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