Provider Demographics
NPI:1164709622
Name:HOANG, THUY T (PHARMD)
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:T
Last Name:HOANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TWIN LAKE XING
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-0700
Mailing Address - Country:US
Mailing Address - Phone:601-447-1111
Mailing Address - Fax:601-554-9781
Practice Address - Street 1:103 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PETAL
Practice Address - State:MS
Practice Address - Zip Code:39465-2313
Practice Address - Country:US
Practice Address - Phone:601-554-3236
Practice Address - Fax:601-554-9781
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-0100221835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist