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General NPI Number Information
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NPI Number | 1982698528
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Entity Type | Individual
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Provider Name | DAT D NGUYEN MD
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Gender | Male
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1739 E BEVERLY AVE STE 203
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City | KINGMAN
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State | AZ
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Zip | 86409-3593
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Country | US
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Telephone | 928-757-3133
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Fax | 928-757-3136
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Provider Business Mailing Address
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Address Line | 3269 N STOCKTON HILL RD
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City | KINGMAN
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State | AZ
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Zip | 86409-3619
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Country | US
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Telephone | 928-757-2101
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 36837
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD2025-0009
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 36837
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License Number State | AZ
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