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General NPI Number Information
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NPI Number | 1770475048
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Entity Type | Individual
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Provider Name | LAM TRUC NGUYEN DC, PHD, CCHT, LRT
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Gender | Male
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Dates
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Enumeration Date | 07/19/2025
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Last Update Date | 07/27/2025
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Provider Practice Location Address
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Address Line | 7 WOODLAND PL
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City | FORT SMITH
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State | AR
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Zip | 72904-2564
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Country | US
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Telephone | 479-226-2002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3135
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City | BENTONVILLE
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State | AR
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Zip | 72712-7711
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Country | US
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Telephone | 479-226-2002
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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