Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 88568 | OH |
N | 2080P0214X | Pediatric Pulmonologist | MD.11827R | LA |
NPI | 1083642565 |
---|---|
Provider Name | Dr. Narong Simakajornboon |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 06/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1481840 | (05) | LA |
2695776 | (05) | OH |
G98344 | (02) |