Individual
PHILLIP T NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 N STATE ST, JACKSON, MS 39202-2064
(601) 982-6001
(601) 982-8616
Mailing address
PO BOX 16076, JACKSON, MS 39236-6076
(601) 982-6001
(601) 982-8616
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
41357
TN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
14929
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116449
—
MS
Enumeration date
06/21/2006
Last updated
01/26/2016
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