Provider Demographics
NPI:1679332456
Name:DO, PHUONG-THAO (MASTER OF ART PHD)
Entity Type:Individual
Prefix:
First Name:PHUONG-THAO
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:MASTER OF ART PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N WESTOVER BLVD.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707
Mailing Address - Country:US
Mailing Address - Phone:229-405-6249
Mailing Address - Fax:229-329-4373
Practice Address - Street 1:AAPHC RENAISSANCE CENTER
Practice Address - Street 2:2403 OLSER COURT, SUITE B
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707
Practice Address - Country:US
Practice Address - Phone:229-639-3135
Practice Address - Fax:229-639-3141
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program