Individual
CHOM PHOU NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
535 JESSE JEWELL PKWY SE STE C, GAINESVILLE, GA 30501-3772
(770) 534-9014
(770) 534-9012
Mailing address
535 JESSE JEWELL PKWY SE STE C, GAINESVILLE, GA 30501-3772
(770) 534-9014
(770) 534-9012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10988
GA
Other
Enumeration date
08/13/2020
Last updated
02/16/2023
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