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General NPI Number Information
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NPI Number | 1700235983
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Entity Type | Individual
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Provider Name | HUONG-THAO THY TRAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 270 JAMES BOHANAN DR
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City | VANDALIA
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State | OH
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Zip | 45377-2342
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Country | US
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Telephone | 937-915-6531
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Fax | 937-421-8919
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Provider Business Mailing Address
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Address Line | 270 JAMES BOHANAN DR
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City | VANDALIA
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State | OH
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Zip | 45377-2342
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Country | US
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Telephone | 937-915-6531
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Fax | 937-421-8919
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MMD.39729 LL
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.136600
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License Number State | OH
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