Search › Minnesota › 207RG0100X
Parkpoom Phatharacharukul, M.D
NPI 1205254547 · on the registry since 2014 · sole proprietor
Practice
- Address
- 6500 Excelsior Blvd
St Louis Park, MN 55426 - Phone
- (952) 993-3240
- Organisation at this address
- Park Nicollet Methodist Hospital
Park Nicollet Methodist Hospital
Park Nicollet Methodist Hospital
Park Nicollet Methodist Hospital
Park Nicollet Methodist HospitalInferred from a shared address, not stated in the registry. - Clinicians at this address
- 598
Additional practice sites
- 420 Delaware St Se, Minneapolis, MN
- 1205 S Grange Ave Ste 510, Sioux Falls, SD
- 702 Rotary Cir Ste 225, Indianapolis, IN
Registry record
- Primary taxonomy
- 207RG0100X
207RG0100X
- Also registered as
- 390200000X
207RG0100X - Licence states on file
- SD, MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-10-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota