Provider Demographics
NPI:1477670198
Name:TRUONG, DUC N (MD)
Entity Type:Individual
Prefix:DR
First Name:DUC
Middle Name:N
Last Name:TRUONG
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 1:9520 W PALM LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4403
Mailing Address - Country:US
Mailing Address - Phone:877-809-5092
Mailing Address - Fax:623-386-4593
Practice Address - Street 1:306 E MONROE AVE
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-2706
Practice Address - Country:US
Practice Address - Phone:877-809-5092
Practice Address - Fax:623-386-4593
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEEC061040390200000X
AZ41476207Q00000X
NV12990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program