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NPI Code Detail

MEDICARE: THUAN V. PHAM M. D.

MEDICARE:   THUAN V. PHAM  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
1207Q00000XFamily Medicine Physician22476OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122476OTHEROKLICENSE
200354010OTHEROKRAILROAD
330803OTHEROKOBNDD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144330218
Entity Type Code : Individual
Provider Name (Legal Business Name) : THUAN V. PHAM M. D.
Provider Business Mailing Address
First Line : 4401 W MEMORIAL RD
Second Line : SUITE 140
City : OKLAHOMA CITY
State : OK
Zip : 73134-1785
Country : US
Telephone Number : 405-752-3162
Fax Number : 405-936-5211
Provider Business Practice Location Address
First Line : 9100 N MAY AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-4417
Country : US
Telephone Number : 405-840-4456
Fax Number : 405-840-4295
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 05/20/2014

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