Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME80081 | FL |
Y | 208600000X | Surgeon | ME80081 | FL |
N | 2086S0105X | Surgery of the Hand | ME80081 | FL |
NPI | 1033117791 |
---|---|
Provider Name | Dr. Tong C. Duong |
First Address | Lynn Haven, FL 32444-4290 |
Second Address | Lynn Haven, FL 32444-4290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 11/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
593031310 | FEDERAL TAX ID (01) | |
E61788 | (02) |