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General NPI Number Information
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NPI Number | 1164001624
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Entity Type | Individual
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Provider Name | ANTHONY HOAN NGUYEN MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2021
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 8300 CONSTANTIN BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70809-3489
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Country | US
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Telephone | 225-374-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 9227 BOONE DR
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City | BATON ROUGE
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State | LA
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Zip | 70810-2656
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Country | US
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Telephone | 504-613-7691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 341572
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License Number State | LA
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