MR. PHOKHAM SOURIVANH, PA-C
Physician Assistant - Medical
Active
Individual
NPI: 1972022762
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Military Health Care Provider | 171000000X | No | - |
| Physician Assistant - Medical | 363AM0700X | Yes | - |
Frequently Asked Questions
NPI 1972022762 is the National Provider Identifier for MR. PHOKHAM SOURIVANH, PA-C, a Physician Assistant - Medical provider located in Pensacola, FL. This NPI was enumerated on September 13, 2017.
MR. PHOKHAM SOURIVANH, PA-C practices at NMRTC PENSACOLA 6000 WEST HIGHWAY 98, Pensacola, FL 32512.
Quick Facts
- NPI
- 1972022762
- Type
- Individual
- Enumerated
- Sep 13, 2017
- Last Updated
- Jun 24, 2025
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