Individual
DR. THOMAS A NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
97 HEFNER ST STE 202, EAST ELLIJAY, GA 30540-8268
(706) 635-5177
(706) 635-5171
Mailing address
97 HEFNER ST STE 202, EAST ELLIJAY, GA 30540-8268
(706) 635-5177
(706) 635-5171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
062579
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006600183A
—
GA
01
—
52254127
B/CB/S
GA
Enumeration date
07/25/2006
Last updated
07/21/2022
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