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NPI Code Detail

MEDICARE: DR. THINH DUC NGUYEN M.D.

MEDICARE: DR. THINH DUC NGUYEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianE-7101AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023278983
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THINH DUC NGUYEN M.D.
Provider Business Mailing Address
First Line : PO BOX 776084
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6084
Country : US
Telephone Number : 314-543-6979
Fax Number : 314-364-6321
Provider Business Practice Location Address
First Line : 2100 N 62ND ST STE A
Second Line :
City : FORT SMITH
State : AR
Zip : 72904-5163
Country : US
Telephone Number : 479-431-3700
Fax Number : 479-431-3738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2008
Last Update Date : 01/15/2025

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