Provider Demographics
NPI:1295850568
Name:VUTPAKDI, AKOM (MD)
Entity Type:Individual
Prefix:DR
First Name:AKOM
Middle Name:
Last Name:VUTPAKDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3018 SUTTON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-9606
Mailing Address - Country:US
Mailing Address - Phone:813-719-1677
Mailing Address - Fax:
Practice Address - Street 1:3018 SUTTON WOODS DR
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-9606
Practice Address - Country:US
Practice Address - Phone:813-719-1677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE02112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology