Provider Demographics
NPI:1013015361
Name:TRAN, KHUE N (MD)
Entity Type:Individual
Prefix:
First Name:KHUE
Middle Name:N
Last Name:TRAN
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 1:207 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HODGENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42748
Mailing Address - Country:US
Mailing Address - Phone:270-358-3829
Mailing Address - Fax:270-358-8350
Practice Address - Street 1:207 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HODGENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42748
Practice Address - Country:US
Practice Address - Phone:270-358-3829
Practice Address - Fax:270-358-8350
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25019207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64250194Medicaid
D08126Medicare UPIN
1447201Medicare ID - Type Unspecified