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Individual

DR. CHUONG NGUYEN THAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
(502) 925-7238
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
(850) 883-8600

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23596
NE
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
10/04/2012
Last updated
08/02/2021
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