NPI 1013049212

Niranat Dejtiranukul, MD

Practitioner Otolaryngology Physician Olney, IL

Practice location

Address: 800 E Locust St, Olney, IL 62450-2553
Phone: (618) 395-7340
Mailing address: PO Box 97, Olney, IL 62450-0097

Registered specialties (2)

Otolaryngology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Y00000X Licence 036-050750 (IL)

Other Otolaryngology providers in Illinois →

Otolaryngic Allergy Physician

Allopathic & Osteopathic Physicians Taxonomy 207YX0602X Licence 036-050750 (IL)

Registry record

NPI: 1013049212
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Mar 2007
Record last updated: 28 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.