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General NPI Number Information
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NPI Number | 1447217328
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Entity Type | Individual
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Provider Name | PHO M. NGUYEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 613 23RD ST STE 520
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City | ASHLAND
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State | KY
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Zip | 41101-2878
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Country | US
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Telephone | 606-393-0190
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Fax | 606-393-5169
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Provider Business Mailing Address
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Address Line | PO BOX 1595
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City | ASHLAND
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State | KY
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Zip | 41105-1595
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Country | US
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Telephone | 606-408-6200
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Fax | 606-408-6612
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35083806
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 41780
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License Number State | KY
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