Provider Demographics
NPI:1477654358
Name:NGUYEN, VIEN XUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VIEN
Middle Name:XUAN
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 1:3269 STOCKTON HILL RD.
Mailing Address - Street 2:KINGMAN REGIONAL MEDICAL CENTER, HOSPITAL MEDICINE
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409
Mailing Address - Country:US
Mailing Address - Phone:928-681-8577
Mailing Address - Fax:480-383-6121
Practice Address - Street 1:3269 STOCKTON HILL RD.
Practice Address - Street 2:KINGMAN REGIONAL MEDICAL CENTER, HOSPITAL MEDICINE
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409
Practice Address - Country:US
Practice Address - Phone:928-681-8577
Practice Address - Fax:480-383-6121
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine