Provider Demographics
NPI:1528137304
Name:NGUYEN, THUY T T (MD)
Entity type:Individual
Prefix:DR
First Name:THUY
Middle Name:T T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 N PENN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7915
Mailing Address - Country:US
Mailing Address - Phone:405-524-8262
Mailing Address - Fax:405-605-6396
Practice Address - Street 1:3109 N PENN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7915
Practice Address - Country:US
Practice Address - Phone:405-524-8262
Practice Address - Fax:405-605-6396
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20094207R00000X
OK20095207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100138040BMedicaid
OKG74475Medicare UPIN
OK100138040BMedicaid