Thao Tp Nguyen, DO | |
402 W Lake St, Friendship, WI 53934-9699 | |
(608) 339-3331 | |
Not Available |
Full Name | Thao Tp Nguyen |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 402 W Lake St, Friendship, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689609364 | NPI | - | NPPES |
P00458926 | Other | OR | RR MEDICARE |
275291 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | DO25094 (Oregon) | Secondary |
207Q00000X | Family Medicine | 62437 (Wisconsin) | Primary |
Entity Name | Sky Lakes Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659340370 PECOS PAC ID: 1052204096 Enrollment ID: O20040204000577 |
Entity Name | Broadway Medical Clinic Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720082316 PECOS PAC ID: 2466447610 Enrollment ID: O20040416001171 |
Mailing Address | Practice Location Address |
---|---|
Thao Tp Nguyen, DO 402 W Lake St, Friendship, WI 53934-9699 Ph: (608) 339-3331 | Thao Tp Nguyen, DO 402 W Lake St, Friendship, WI 53934-9699 Ph: (608) 339-3331 |
Paul A Kornaus, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 402 W Lake St, Friendship, WI 53934 Phone: 608-339-3331 Fax: 608-339-8323 | |
Mark E Hatton, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 402 West Lake Street, Friendship, WI 53934 Phone: 608-339-6350 | |
Dr. Richie-ann Soriano Rodriguez, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 402 West Lake Street, Friendship, WI 53934 Phone: 608-339-3331 |