Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 25019 | KY |
Y | 111NI0900X | Internist | 25019 | KY |
N | 208000000X | Pediatrician | 25019 | KY |
NPI | 1013015361 |
---|---|
Provider Name | Khue N Tran |
First Address | Hodgenville, KY 42748 |
Second Address | Hodgenville, KY 42748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64250194 | (05) | KY |
D08126 | (02) |