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NPI Code Detail

MEDICARE: DR. SUTHIN SONGCHAROEN M.D.

MEDICARE: DR. SUTHIN SONGCHAROEN 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
1174400000XSpecialist07163MS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CK7048OTHERMEDICARE RAILROAD GROUP
3C03036OTHERMEDICARE PTAN
4660002223OTHERMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255329371
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUTHIN SONGCHAROEN M.D.
Provider Business Mailing Address
First Line : 2 DEERFIELD DR
Second Line :
City : MADISON
State : MS
Zip : 39110-9749
Country : US
Telephone Number : 601-856-7372
Fax Number : 601-420-5482
Provider Business Practice Location Address
First Line : 2550 FLOWOOD DR
Second Line : #300
City : FLOWOOD
State : MS
Zip : 39232-9303
Country : US
Telephone Number : 601-420-0034
Fax Number : 601-420-5482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 08/11/2009

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Directions to “ DR. SUTHIN SONGCHAROEN M.D.” Practice Location

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