Sipong Patamasucon

NPI 1316747256 · on the registry since 2025

Practice

Address: 1801 Mesquite Ave
Lake Havasu City, AZ 86403
Phone: (928) 854-5400
Organisation at this address: Frederic Luo, Md, Msee, Inc
Smith Tryon Family Health Inc D.B.A. Blue Water Medical
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Additional practice sites

2350 Miracle Mile, Bullhead City, AZ
1815 N Stockton Hill Rd, Kingman, AZ

Registry record

Primary taxonomy: 363A00000X
363A00000X
Licence states on file: AZ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-03-18

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 Arizona