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NPI Code Detail

MEDICARE: DR. TONG C. DUONG M.D.

MEDICARE: DR. TONG C. DUONG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208200000XPlastic Surgery PhysicianME80081FL
22086S0105XSurgery of the Hand (Surgery) PhysicianME80081FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1593031310OTHERFEDERAL TAX ID

General Provider Information

NPI Number : 1033117791
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TONG C. DUONG M.D.
Provider Business Mailing Address
First Line : 1702 OHIO AVE
Second Line :
City : LYNN HAVEN
State : FL
Zip : 32444-4290
Country : US
Telephone Number : 850-647-8825
Fax Number : 850-248-8825
Provider Business Practice Location Address
First Line : 1702 OHIO AVE
Second Line :
City : LYNN HAVEN
State : FL
Zip : 32444-4290
Country : US
Telephone Number : 850-647-8825
Fax Number : 850-248-8825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 09/11/2013

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Directions to “ DR. TONG C. DUONG M.D.” Practice Location

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