Pawat Poupongtong, DPT
Physical Therapist in Buckeye, AZ. Individual provider (NPI-1).
NPI number1902407976
StatusActive
Last updated in NPPESNov 5, 2020
Details
- NPI
- 1902407976
- Entity type
- Individual (NPI-1)
- Name
- Pawat Poupongtong
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 5, 2020
- Certification date
- Nov 5, 2020
- Last updated
- Nov 5, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- 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 |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 30798 | AZ | Yes |
Practice location
23350 W Yuma RdBuckeye, AZ 85326-3106
Phone 623-242-6908
Mailing address
17830 N 45th AveGlendale, AZ 85308-1650
Phone 562-455-3886
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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