MEDICARE: THAI-HAO NGUYEN MD

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	207Q00000X	Family Medicine Physician	30790	OK

General Provider Information

NPI Number	:	1609296557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THAI-HAO NGUYEN MD

Provider Business Mailing Address
First Line	:	3325 NW 173RD ST
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73012-7102
Country	:	US
Telephone Number	:	405-926-1407
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 W MAIN ST # 1034
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-2221
Country	:	US
Telephone Number	:	405-926-1407
Fax Number	:

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

Provider Enumeration Date	:	04/18/2014
Last Update Date	:	06/03/2025

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Directions to “ THAI-HAO NGUYEN MD” Practice Location

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