Dr Kobkit Putrakul, MD | |
210 Marie Langdon Dr, Manchester, KY 40962 | |
(606) 598-5104 | |
(606) 983-7252 |
Full Name | Dr Kobkit Putrakul |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 210 Marie Langdon Dr, Manchester, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699951558 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | TP656 (Kentucky) | Secondary |
207P00000X | Emergency Medicine | 41570 (Kentucky) | Primary |
Entity Name | Memorial Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831150119 PECOS PAC ID: 4486616141 Enrollment ID: O20041103001183 |
Entity Name | Southeastern Emergency Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 |
Entity Name | Concord Medical Group Of Kentucky Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346746385 PECOS PAC ID: 9133483894 Enrollment ID: O20180503002233 |
Mailing Address | Practice Location Address |
---|---|
Dr Kobkit Putrakul, MD 600 Greenway Dr, London, KY 40741-1629 Ph: (606) 401-5490 | Dr Kobkit Putrakul, MD 210 Marie Langdon Dr, Manchester, KY 40962 Ph: (606) 598-5104 |
Ashraf Azeb, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 210 Marie Langdon Dr, Manchester, KY 40962 Phone: 606-598-5104 Fax: 865-291-3228 |