MEDICARE: TIMOTHY HOANG NGUYEN DO

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
1	207R00000X	Internal Medicine Physician	94-11114	KS
2	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	94-11114	KS

General Provider Information

NPI Number	:	1528798022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY HOANG NGUYEN DO

Provider Business Mailing Address
First Line	:	1010 N KANSAS ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-3124
Country	:	US
Telephone Number	:	316-293-2665
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD # MS 2026
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-3124
Country	:	US
Telephone Number	:	913-588-6009
Fax Number	:	913-588-3987

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	07/01/2025

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