SOURASACK K. VONGSA MD – NPI #1619945524
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.
SOURASACK VONGSA is a physician located in APPLETON, WI. NPPES has assigned the NPI number 1619945524 to SOURASACK VONGSA on March 08, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.
The NPI profile was previously updated about 7 years ago on Aug 19, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOURASACK VONGSA below.
NPI Profile for
SOURASACK K. VONGSA
(more than 20 years ago)
APPLETON, WI 54911 Phone: (920) 830-6877 Fax: (800) 236-2236
1 Other location(s):
Appleton, WI 54911
Phone: (920) 380-2727
Fax: (920) 380-2726
APPLETON, WI 54911-5794 Phone: (920) 996-3264 Fax: (920) 830-5970
Identifiers for SOURASACK VONGSA
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| MEDICAID | WI | 34808400 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 207Q00000X - Family Medicine (Primary) |
WI | 47253 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
SOURASACK VONGSA is affiliated with the following medical group(s):
- HOSPITAL
- THEDACARE REGIONAL MED CTR - NEENAH130 2ND ST
NEENAH, WI 54956
- THEDACARE REGIONAL MED CTR - NEENAH130 2ND ST
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