Provider Demographics
NPI:1295027647
Name:NGUYEN, ALBERT T (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:T
Last Name:NGUYEN
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 1:2636 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-5823
Mailing Address - Country:US
Mailing Address - Phone:405-602-5330
Mailing Address - Fax:405-603-6474
Practice Address - Street 1:2636 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-5823
Practice Address - Country:US
Practice Address - Phone:405-602-5330
Practice Address - Fax:405-603-6474
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28578208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice