Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME44188 | FL |
NPI | 1043308588 |
---|---|
Provider Name | Dr. Hiep Q Nguyen |
First Address | Jacksonville, FL 32207-8209 |
Second Address | Macclenny, FL 32063-5451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |