Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT002057 | GA |
NPI | 1003808056 |
---|---|
Provider Name | Dr. Nancy Y Truong |
First Address | Loganville, GA 30052-7316 |
Second Address | Decatur, GA 30033-6197 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2200336 | UNITED HEALTHCARE (01) | GA |
306019142A | (05) | GA |
52025961 | BC&BS (01) | GA |
U97574 | (02) | GA |