Provider Demographics
NPI:1679387351
Name:AROONSAKULWONGSE, ATIA (PA)
Entity type:Individual
Prefix:
First Name:ATIA
Middle Name:
Last Name:AROONSAKULWONGSE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MONTGOMERY HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2805
Mailing Address - Country:US
Mailing Address - Phone:205-783-5900
Mailing Address - Fax:205-971-1927
Practice Address - Street 1:1021 MONTGOMERY HWY STE 201
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-2805
Practice Address - Country:US
Practice Address - Phone:205-783-5900
Practice Address - Fax:205-971-1927
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA1934363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical