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General NPI Number Information
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NPI Number | 1881815520
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Entity Type | Organization
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Legal Business Name | JACKSON COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 3051 6TH ST
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City | MARIANNA
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State | FL
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Zip | 32446-1933
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Country | US
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Telephone | 850-718-2644
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Fax | 850-718-2894
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Provider Business Mailing Address
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Address Line | 3051 6TH ST
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City | MARIANNA
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State | FL
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Zip | 32446-1933
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Country | US
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Telephone | 850-718-2644
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Fax | 850-718-2894
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. VECHAI LEE ARUNAKUL
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Credential | M.D.
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Telephone | 850-718-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME98090
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License Number State | FL
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