Provider Demographics
NPI:1962700070
Name:NGO, WILLIAM VINH (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VINH
Last Name:NGO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:744 MIDDLE CREEK RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-5015
Mailing Address - Country:US
Mailing Address - Phone:865-446-9550
Mailing Address - Fax:
Practice Address - Street 1:744 MIDDLE CREEK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5015
Practice Address - Country:US
Practice Address - Phone:865-446-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN29782086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ021873Medicaid
TNQ021873Medicaid