NPI Code Detail JSON Logo

1518306570 NPI number — YUTTANA CHAWENGSUB M.D., PH.D.

NPI Number: 1518306570
Health Care Provider/Practitioner: YUTTANA CHAWENGSUB M.D., PH.D.

Information about “1518306570” NPI (YUTTANA CHAWENGSUB M.D., PH.D.) exists in 1518306570 in HTML format HTML  |  1518306570 in plain Text format TXT  |  1518306570 in PDF (Portable Document Format) PDF  |  1518306570 in an XML format XML  formats.

NPI Number : 1518306570 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518306570",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHAWENGSUB",
    "FirstName": "YUTTANA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D., PH.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "800 MERCY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COUNCIL BLUFFS",
    "MailingAddressStateName": "IA",
    "MailingAddressPostalCode": "51503-3128",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "855-524-4001",
    "MailingAddressFaxNumber": "712-325-2499",
    "FirstLinePracticeLocationAddress": "800 MERCY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COUNCIL BLUFFS",
    "PracticeLocationAddressStateName": "IA",
    "PracticeLocationAddressPostalCode": "51503-3128",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "855-524-4001",
    "PracticeLocationAddressFaxNumber": "712-325-2499",
    "EnumerationDate": "06/22/2013",
    "LastUpdateDate": "02/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "125063902",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "MD61203457",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "04-40350",
          "LicenseNumberStateCode": "KS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "MD2022-1256",
          "LicenseNumberStateCode": "NM",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208M00000X",
          "TaxonomyName": "Hospitalist Physician",
          "LicenseNumber": "CP1338",
          "LicenseNumberStateCode": "NE",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208M00000X",
          "TaxonomyName": "Hospitalist Physician",
          "LicenseNumber": "MD-43157",
          "LicenseNumberStateCode": "IA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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