Provider Demographics
NPI:1992774608
Name:NGUYEN, HY K (MD)
Entity type:Individual
Prefix:
First Name:HY
Middle Name:K
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 W LINCOLN TRAIL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-2604
Mailing Address - Country:US
Mailing Address - Phone:270-351-1850
Mailing Address - Fax:270-351-1855
Practice Address - Street 1:750 W LINCOLN TRAIL BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-2604
Practice Address - Country:US
Practice Address - Phone:270-351-1850
Practice Address - Fax:270-351-1855
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY24932208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64249329Medicaid
KY64249329Medicaid
G 29421Medicare UPIN