Provider Demographics
NPI:1215566690
Name:TRAN, KHIEM (MD)
Entity Type:Individual
Prefix:
First Name:KHIEM
Middle Name:
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 1:5135 N VIA CONDESA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5713
Mailing Address - Country:US
Mailing Address - Phone:415-887-8352
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Practice Address - Street 2:4301 WEST MARKHAM, SLOT 634
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-5162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program