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NPI Code Detail

MEDICARE: KIMBERLY NGUYEN OD

MEDICARE: KIMBERLY NGUYEN OD
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
1152W00000XOptometrist6522OH

General Provider Information

NPI Number : 1619496072
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY NGUYEN OD
Provider Business Mailing Address
First Line : 4012 EASTON STA
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6080
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4012 EASTON STA
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6080
Country : US
Telephone Number : 614-478-0901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2017
Last Update Date : 09/15/2017

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Directions to “ KIMBERLY NGUYEN OD” Practice Location

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