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General NPI Number Information
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NPI Number | 1942452255
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Entity Type | Individual
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Provider Name | JOHN QUANG NGUYEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1823 HURLBURT RD STE 7
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-3748
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Country | US
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Telephone | 850-226-8254
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Fax | 850-226-6602
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | SHALIMAR
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State | FL
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Zip | 32579-0936
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Country | US
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Telephone | 850-226-8254
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Fax | 850-226-6602
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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 | 4301092671
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License Number State | MI
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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 | P1906
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME131654
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License Number State | FL
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