Healthcare Provider Details

I. General information

NPI: 1689622839
Provider Name (Legal Business Name): FRANCIS TUNG NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: TUNG HUU NGUYEN M.D

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MAIN ST
CHATTAHOOCHEE FL
32324-1107
US

IV. Provider business mailing address

100 N MAIN ST
CHATTAHOOCHEE FL
32324-1107
US

V. Phone/Fax

Practice location:
  • Phone: 850-663-7443
  • Fax:
Mailing address:
  • Phone: 850-663-7443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME45125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: