Individual
MR. KHAI C TRUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1860 JH OBRYAN AVE, GRAND RIVERS, KY 42045-9049
(270) 362-8246
(270) 362-9757
Mailing address
131 HOSPITAL DR, SALEM, KY 42078-8043
(270) 988-7256
(270) 988-3900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39284
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000370768
BC/BS
KY
01
—
000000623499
ANTHEM BC&BS
KY
05
—
64088784
—
KY
05
—
65944019
—
KY
05
—
7100091610
—
KY
Enumeration date
12/16/2005
Last updated
08/09/2016
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