Anupong Chotimongkol, MD

Individual provider Active NPI Gynecology Physician · Dodge City, KS

NPI 1932180403 · NPPES record last updated Jan 22, 2014

Key facts

NPI
1932180403
Entity type
Individual (NPI type 1)
Primary specialty
Gynecology Physician 207VG0400X
License
0416467 (KS)
Practice address
2020 Central Avenue
Dodge City, KS 67801-1000
Phone
(620) 227-1371
Fax
(620) 227-1208
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0416467KSMDGynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 0416467 KS Yes

Addresses

Primary practice location

2020 Central Avenue
Dodge City, KS 67801-1000

Mailing address

2020 Central Avenue
Dodge City, KS 67801-1000
Phone (620) 227-1371

Other identifiers

IdentifierTypeStateIssuer
100084030AMedicaidKS

Other providers in Dodge City, KS

All providers in Dodge City, KS · Gynecology Physician in Kansas

Sources for this page

Verify at the official NPI Registry.