Healthcare Provider Details

I. General information

NPI: 1003662230
Provider Name (Legal Business Name): DUY KHOA NGUYEN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DENNIS NGUYEN DO

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 E 22ND ST
TUCSON AZ
85710-8509
US

IV. Provider business mailing address

7901 E 22ND ST
TUCSON AZ
85710-8509
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax: 520-694-8466
Mailing address:
  • Phone: 520-694-8888
  • Fax: 520-694-8466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR4887
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: