Mr Scott Gould Kingphavong, LMT is a
Massage Therapist based in Oak Forest, Illinois. Mr Scott Gould Kingphavong is licensed to practice in Illinois (license number 227.014953) and his current practice location is
5936 Essex Rd, Oak Forest, Illinois. He can be reached at his office (for appointments etc.) via phone at
(779) 774-5493.
NPI number for Mr Scott Gould Kingphavong is 1710333638 and his current mailing address is 5936 Essex Rd, Oak Forest, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710333638.
Healthcare Provider's Profile
Full Name | Mr Scott Gould Kingphavong |
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Gender | Male |
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Speciality | Massage Therapist |
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Location | 5936 Essex Rd, Oak Forest, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1710333638
- Provider Enumeration Date: 05/10/2016
- Last Update Date: 10/01/2020
Medical Identifiers
Medical identifiers for Mr Scott Gould Kingphavong such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710333638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225700000X | Massage Therapist | 227.014953 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Scott Gould Kingphavong is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Scott Gould Kingphavong, LMT 5936 Essex Rd, Oak Forest, IL 60452-2824 Ph: (779) 774-5493 | Mr Scott Gould Kingphavong, LMT 5936 Essex Rd, Oak Forest, IL 60452-2824 Ph: (779) 774-5493 |
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