VATANA C. BOONYASAI (NPI# 1326008533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326008533 |
| Entity Type | Individual |
| Full Name | VATANA C. BOONYASAI |
| Credential | M.D/ |
| Practice Address |
200 St.mary's Street Lower Level Pilot Knob MO 63650 |
| Mailing Address |
Po Box 527 Pilot Knob MO 63663-0527 |
| Practice Telephone | 5735463929 |
| Practice Fax Number | 5735463962 |
| Mailing Telephone | 5735463929 |
| Mailing Fax Number | 5735463962 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 33968 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
200 ST.MARY'S STREET LOWER LEVEL |
| City | PILOT KNOB |
| State | MO |
| Zip Code | 63650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972756633 | East Missouri Action Agency, Inc | Clinic/Center | 606 West Russell, Ironton, MO 63650 | 2008-10-28 |
| 1194074302 | Robert Franklin Dettmer Sr. | General Practice | 3 Longwood Lane, Ironton, MO 63650-0307 | 2012-09-04 |
| 1578542924 | Arcadia Valley Drug Acquisition Co | Durable Medical Equipment & Medical Supplies | 605 N Main St, Ironton, MO 63650-1006 | 2006-01-13 |
| 1053978643 | Michelle Bobbett | Pharmacist | 605 N Main St, Ironton, MO 63650-1006 | 2019-05-20 |
| 1184016578 | Rebecca Barron | Pharmacist | 605 N Main St, Ironton, MO 63650-1006 | 2015-02-23 |
| 1902152929 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 605 N Main St, Ironton, MO 63650-1006 | 2012-07-27 |
| 1831457027 | Frederick G Dietzler | Pharmacist | 605 N Main St, Ironton, MO 63650-1006 | 2012-04-25 |
| 1831417682 | Southeast Missouri Behavioral Health | Clinic/Center | 143 S Main St, Ironton, MO 63650-1305 | 2010-05-04 |
| 1942451083 | Erika Michelle Parks | Pharmacist | 124 W Russell St, Ironton, MO 63650-1313 | 2008-10-07 |
| 1417050659 | John David Auner | Family Medicine | 128 W Russell St, Ironton, MO 63650-1313 | 2006-09-06 |
| Find all providers in zip 63650 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255485678 | Karen Lin Duberstein | Family Medicine | 301 North Highway 21, Pilot Knob, MO 63663 | 2007-01-23 |
| 1992819627 | Harry Taylor Harness | Family Medicine | 315 West Mulberry Street, Pilot Knob, MO 63663 | 2006-08-19 |
| 1518927722 | Boonfu Boonyasai | Family Medicine | 200 St. Marys Street, Lower Level, Pilot Knob, MO 63663 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596877 | Stephanie R Nicholson | Family Medicine | 4500 S Park Ave, Sedalia, MO 65301-8525 | 2020-10-21 |
| 1053919514 | Kelli Lichte | Family Medicine | 601 S 13 Hwy, Lexington, MO 64067-1511 | 2020-10-15 |
| 1053927228 | Cox- Monett Hospital, Inc. | Family Medicine | 1000 E Hwy 60, Monett, MO 65708 | 2020-09-22 |
| 1104432806 | Jefferson Medical Group | Family Medicine | 807 E Broadway St, Brunswick, MO 65236-1468 | 2020-09-17 |
| 1124633995 | Continuum Family Care LLC | Family Medicine | 2336 S Main St, Maryville, MO 64468-3622 | 2020-09-09 |
| 1326652579 | Linda Diane Watson | Family Medicine | 338 Emerson Rd Apt 104, High Ridge, MO 63049-2530 | 2020-09-04 |
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1013542828 | Johns Healthcare Services LLC | Family Medicine | 2001 Independence St Ste A, Cape Girardeau, MO 63703-5805 | 2020-03-12 |
| 1972133460 | Fnp4jc, LLC | Family Medicine | 215 North Street, Waynesville, MO 65583 | 2020-01-23 |
| 1568092732 | Scotland County Memorial Hospital | Family Medicine | 55682 State Highway 6, Edina, MO 63537-4267 | 2020-01-16 |
| Find all providers with the same taxonomy | ||||
| City | PILOT KNOB |
| Zip Code | 63650 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.