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General NPI Number Information
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NPI Number | 1609832369
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Entity Type | Organization
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Legal Business Name | PREECHA BHOTIWIHOK MD, PA
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Dates
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Enumeration Date | 04/21/2006
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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 | PRESIDENT
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Name | PREECHA BHOTIWIHOK
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Credential | MD
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Telephone | 800-277-8151
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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 |
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License Number State |
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