Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 28771 | MS |
N | 207NP0225X | Pediatric Dermatologist | 28771 | MS |
NPI | 1043745243 |
---|---|
Provider Name | Dr. Thy Huynh |
First Address | Clinton, MS 39056 |
Second Address | Jackson, MS 39216-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2017 |
Last Update Date | 02/12/2021 |