Temiyasathit, Thanom

Temiyasathit, Thanom is an individual health care provider with primary practice located at 1302 Franklin Ave Suite 4500, Normal IL 61761-3551. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Temiyasathit, Thanom can be contacted via phone (309) 828-1166.

Contact Information

Primary practice address
1302 Franklin Ave Suite 4500 Normal IL 61761-3551
Phone: (309) 828-1166
Fax: (309) 862-0330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036-054080 Illinois

Profile Details

NPI number 1023041175
LBN Legal business name Temiyasathit, Thanom
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023041175 NPPES
Illinois Other 008003 HEALTH ALLIANCE
Illinois MEDICAID 036054080 HEALTH ALLIANCE
Illinois Other 05732097 HEALTH ALLIANCE

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