Provider Demographics
NPI:1861507873
Name:HANH M. NGUYEN O.D., P.C.
Entity Type:Organization
Organization Name:HANH M. NGUYEN O.D., P.C.
Other - Org Name:VISION SOURCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-951-1897
Mailing Address - Street 1:1200 LAKE HEARN DR NE STE 150
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1445
Mailing Address - Country:US
Mailing Address - Phone:770-951-1897
Mailing Address - Fax:404-459-0475
Practice Address - Street 1:1200 LAKE HEARN DR NE STE 150
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-1445
Practice Address - Country:US
Practice Address - Phone:770-951-1897
Practice Address - Fax:404-459-0475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty