Healthcare Provider Details

I. General information

NPI: 1366706673
Provider Name (Legal Business Name): THOMAS ANH NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5888 CLEVELAND AVE
COLUMBUS OH
43231-2860
US

IV. Provider business mailing address

260 STETSON ST SUITE # 3200
CINCINNATI OH
45219-2498
US

V. Phone/Fax

Practice location:
  • Phone: 614-882-4343
  • Fax:
Mailing address:
  • Phone: 513-558-7700
  • Fax: 513-332-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number35.077860
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: