Provider Demographics
NPI:1669712964
Name:NGUYEN, NATALIE NGA (OD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:NGA
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2637
Mailing Address - Country:US
Mailing Address - Phone:234-643-9326
Mailing Address - Fax:614-705-6463
Practice Address - Street 1:1001 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2637
Practice Address - Country:US
Practice Address - Phone:234-643-9326
Practice Address - Fax:614-705-6463
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013004092152W00000X
KS1945152W00000X
OH6423152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist