MEDICARE: DR. TONY N. TRAN MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	171000000X	Military Health Care Provider

General Provider Information

NPI Number	:	1477138501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONY N. TRAN MD

Provider Business Mailing Address
First Line	:	2115 WESTHAVEN DR
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-6181
Country	:	US
Telephone Number	:	770-539-4706
Fax Number	:	903-213-9097

Provider Business Practice Location Address
First Line	:	USS ASHLAND LSD 48
Second Line	:	UNIT 100147
City	:	FPO
State	:	AP
Zip	:	96660
Country	:	US
Telephone Number	:	770-539-4706
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2021
Last Update Date	:	05/02/2024

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