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General NPI Number Information
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NPI Number | 1659943546
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Entity Type | Organization
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Legal Business Name | DUC NGUYEN PODIATRY LLC
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 10/16/2022
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Provider Practice Location Address
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Address Line | 7509 STATE ROAD 13 N
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-2230
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Country | US
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Telephone | 904-417-8894
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Fax | 877-370-4468
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Provider Business Mailing Address
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Address Line | 7509 STATE ROAD 13 N
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-2230
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Country | US
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Telephone | 904-417-8894
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Fax | 877-370-4468
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. DUC NGUYEN
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Credential | DPM
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Telephone | 586-744-9584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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