MR. PHOKHAM SOURIVANH, PA-C

Physician Assistant - Medical

Active Individual
NPI: 1972022762

Practice Address

NMRTC PENSACOLA 6000 WEST HIGHWAY 98
Pensacola, FL 32512

Phone: (901) 874-6081

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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