Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR010144 | GA |
N | 111NI0013X | Independent Medical Examiner | CHIR010144 | GA |
N | 207R00000X | Internist | CHIR010144 | GA |
N | 111NI0900X | Internist | CHIR010144 | GA |
N | 111NN0400X | Neurology | CHIR010144 | GA |
N | 111NN1001X | Nutrition | CHIR010144 | GA |
N | 111NP0017X | Pediatric Chiropractor | CHIR010144 | GA |
N | 111NR0200X | Radiology | CHIR010144 | GA |
N | 213ER0200X | Radiology | CHIR010144 | GA |
N | 111NR0400X | Rehabilitation Chiropractor | CHIR010144 | GA |
N | 111NS0005X | Chiropractic Sports Physician | CHIR010144 | GA |
N | 111NT0100X | Thermography | CHIR010144 | GA |
N | 111NX0100X | Occupational Health | CHIR010144 | GA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | CHIR010144 | GA |
NPI | 1962970525 |
---|---|
Provider Name | Dr. Tony Nguyen |
First Address | Lilburn, GA 30047-4108 |
Second Address | Marietta, GA 30067-8764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2018 |
Last Update Date | 12/11/2018 |