Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD-48563 | IA |
N | 208000000X | Pediatrician | 2015018256 | MO |
N | 208000000X | Pediatrician | MD-48563 | IA |
N | 2080P0204X | Pediatric Emergency Doctor | MD-48563 | IA |
NPI | 1043691033 |
---|---|
Provider Name | Dr. Thang V Truong |
First Address | Oklahoma City, OK 73104-5008 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2015 |
Last Update Date | 09/08/2021 |