Individual
PHONG JASON NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3623 J DEWEY GRAY CIR STE 202, AUGUSTA, GA 30909-6554
(067) 863-8155
(706) 863-8175
Mailing address
3623 J DEWEY GRAY CIR STE 202, AUGUSTA, GA 30909-6554
(067) 863-8155
(706) 863-8175
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
009030
GA
207R00000X
Internal Medicine Physician
85054
GA
207RI0011X
Interventional Cardiology Physician
Primary
85054
GA
Other
Enumeration date
05/28/2017
Last updated
07/09/2025
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