Provider Demographics
NPI:1033371323
Name:UNNOPPET, NOPPORN (DO)
Entity Type:Individual
Prefix:
First Name:NOPPORN
Middle Name:
Last Name:UNNOPPET
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:NOP
Other - Middle Name:
Other - Last Name:UNNOPPET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1010 1ST STREET NORTH
Mailing Address - Street 2:STE 210
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007
Mailing Address - Country:US
Mailing Address - Phone:205-620-8676
Mailing Address - Fax:205-620-8673
Practice Address - Street 1:1010 1ST STREET NORTH
Practice Address - Street 2:STE 210
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007
Practice Address - Country:US
Practice Address - Phone:205-620-8676
Practice Address - Fax:205-620-8673
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO1059207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510 48272OtherBCBS ALABAMA
AL107732Medicaid
AL102I668888Medicare PIN