Provider Demographics
NPI:1104211390
Name:DUGGAN, KRISTY TAYAPONGSAK (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:TAYAPONGSAK
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:ANN-MAY
Other - Last Name:TAYAPONGSAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5698
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5272
Practice Address - Country:US
Practice Address - Phone:828-684-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD187192207R00000X
NC2019-00585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine