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NPI Code Detail

MEDICARE: THANH TUYEN THI DO

MEDICARE: THANH TUYEN THI DO
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
1183500000XPharmacist052995460GA

General Provider Information

NPI Number : 1245615434
Entity Type Code : Individual
Provider Name (Legal Business Name) : THANH TUYEN THI DO
Provider Business Mailing Address
First Line : 2465 MARSH RABBIT BND
Second Line :
City : DECATUR
State : GA
Zip : 30035-3018
Country : US
Telephone Number : 404-579-3648
Fax Number :
Provider Business Practice Location Address
First Line : 1367 DOUBLE CHURCHES RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2601
Country : US
Telephone Number : 706-641-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2015
Last Update Date : 07/29/2015

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Directions to “ THANH TUYEN THI DO ” Practice Location

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