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NPI 1467455329

NPI 1467455329 : PREECHA BHOTIWIHOK MD : KINSTON, NC

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General NPI Number Information
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    NPI Number           |    1467455329
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    Entity Type          |    Individual 
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    Provider Name        |    PREECHA BHOTIWIHOK MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/24/2005
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    Last Update Date     |    07/24/2007
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Provider Practice Location Address
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    Address Line         |    100 AIRPORT RD 
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    City                 |    KINSTON
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    State                |    NC
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    Zip                  |    28501-1604
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    Country              |    US
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    Telephone            |    800-277-8151
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    Fax                  |    336-841-6217
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Provider Business Mailing Address
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    Address Line         |    PO BOX 16068 
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    City                 |    HIGH POINT
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    State                |    NC
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    Zip                  |    27261-6068
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    Country              |    US
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    Telephone            |    888-447-7220
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    Fax                  |    336-884-1643
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    22212
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    License Number State |    NC
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