Provider Demographics
NPI:1316149412
Name:TRAN, AI NGOC (MD)
Entity type:Individual
Prefix:
First Name:AI
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6018
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41022-6018
Mailing Address - Country:US
Mailing Address - Phone:859-912-7716
Mailing Address - Fax:859-757-4923
Practice Address - Street 1:6909 BURLINGTON PIKE STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1618
Practice Address - Country:US
Practice Address - Phone:859-912-7716
Practice Address - Fax:859-757-4923
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2020-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY41175207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100137430Medicaid
KYK059620Medicare PIN