Individual
THANG MINH PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 380-4072
(931) 490-7043
Mailing address
854 W JAMES CAMPBELL BLVD, SUITE 303, COLUMBIA, TN 38401-4659
(931) 380-4072
(931) 490-7043
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
52293
TN
207R00000X
Internal Medicine Physician
Primary
52293
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3710089
—
TN
Enumeration date
05/04/2011
Last updated
02/21/2022
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