Vanchai Vongchanyakul, PA
Physician Assistant, Medical in Healdton, OK. Individual provider (NPI-1).
NPI number1790736932
StatusActive
Last updated in NPPESNov 20, 2014
Details
- NPI
- 1790736932
- Entity type
- Individual (NPI-1)
- Name
- Vanchai Vongchanyakul
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 12, 2006
- Last updated
- Nov 20, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA847 | OK | Yes |
Practice location
3462 Hospital RdHealdton, OK 73438-6124
Phone 580-229-0701 · Fax 580-229-1454
Mailing address
530 N Monte Vista StSuite A
Ada, OK 74820-4675
Phone 580-436-7101 · Fax 580-436-4447
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