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SOURASACK VONGSA, MD

MD

Family Medicine Physician

NPI: 1619945524IndividualAccepts Medicare

Specialties, Licenses & Credentials

Family Medicine PhysicianPrimary

Family Medicine

Code: 207Q00000X

47253(WI)

CMS Specialties

PrimaryFAMILY PRACTICE

Education

OTHER

Class of 2003

Contact & Hours

Via practice · 2 locations total

Address
2500 E CAPITOL DR STE 1200
APPLETON, WI 54911

Quick Facts

NPI
1619945524
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
1
Locations
2
Years in Practice
23

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