Individual
DR. THUY T NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 N WASHINGTON AVE, SUITE 201, COOKEVILLE, TN 38501-2660
(931) 528-5633
(931) 528-5798
Mailing address
315 N WASHINGTON AVE, SUITE 201, COOKEVILLE, TN 38501-2603
(931) 528-5633
(931) 528-5798
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25547
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080187007
RAILROAD MEDICARE
TN
05
—
3086391
—
TN
01
—
4037809
BLUE CROSS
TN
01
—
481263448
TAX ID
TN
01
—
TN101
JOHN DEERE
TN
Enumeration date
06/26/2006
Last updated
05/18/2015
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