Organization
KHOA CAO NGUYEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHOA NGUYEN MD (OWNER)
(870) 898-2007
Entity
Organization
Contact information
Practice address
1340 S CONSTITUTION AVE, ASHDOWN, AR 71822-8652
(870) 898-2007
Mailing address
1340 S CONSTITUTION AVE, ASHDOWN, AR 71822-8652
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
C 5496
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103210001
—
AR
Enumeration date
04/21/2011
Last updated
04/21/2011
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