Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 038060 | GA |
NPI | 1063567469 |
---|---|
Provider Name | Dr. Khuong V Nguyen |
First Address | Marietta, GA 30007-0095 |
Second Address | Atlanta, GA 30341-5044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 21/02/2017 |