S. Kulkamthorn MD, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35018 Issued in MO

Legal business name

S. KULKAMTHORN MD, INC.

Practice address

510 W Pearce Blvd
Wentzville, MO 63385-1343

Phone

(636) 332-6660

Fax

(636) 332-6660

NPI assigned

Aug 23, 2010

Organization subpart

Yes

Parent organization

S. KULKAMTHORN MD, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Pamela Eisenbath

Title

Office Manager

Phone

(636) 332-6660

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

S Kulkamthorn MD Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1669788063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W PEARCE BLVD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851343",
            "telephone_number": "636-332-6660",
            "fax_number": "636-332-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W PEARCE BLVD",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851343",
            "telephone_number": "636-332-6660",
            "fax_number": "636-332-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. KULKAMTHORN MD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "S. KULKAMTHORN MD, INC.",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "EISENBATH",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "636-332-6660",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "35018",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "35018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201098019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.