Individual Provider

LBN: Individual Provider
Individual Provider is an health care organization with primary practice located at 307 Boatner Road Suite 114 96Th Medical Group, Eglin FL 32542. The organization recently has only one registered license in Hospitals / Military Hospital, which is considered as the primary health care specialty. Individual Provider can be contacted via phone (850) 883-8600, or through Thai, Chuong Nguyen via phone (850) 883-9055.

Contact Information

Primary practice address
307 Boatner Road Suite 114 96Th Medical Group Eglin FL 32542
Phone: (850) 883-8600
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Thai, Chuong Nguyen Doctor of Medicine (MD)
Phone: (850) 883-9055

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Military Hospital 286500000X

Profile Details

NPI number 1376890293
LBN Legal business name Individual Provider
DBA Doing business as
Authorized official Thai, Chuong Nguyen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 9th, 2012
Last updated Sep 14th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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