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NPI Code Detail

MEDICARE: DR. PACHNEERAT CHAINAKUL M.D.

MEDICARE: DR. PACHNEERAT CHAINAKUL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician12548OK

General Provider Information

NPI Number : 1972615607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PACHNEERAT CHAINAKUL M.D.
Provider Business Mailing Address
First Line : 2029 GORDON COOPER DR
Second Line :
City : SHAWNEE
State : OK
Zip : 74801-9005
Country : US
Telephone Number : 405-878-4702
Fax Number : 405-878-4540
Provider Business Practice Location Address
First Line : 2029 GORDON COOPER DR
Second Line :
City : SHAWNEE
State : OK
Zip : 74801-9005
Country : US
Telephone Number : 405-878-4702
Fax Number : 405-878-4540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 04/23/2012

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