Provider Demographics
NPI:1770183147
Name:DOAN, BICH NGOC THI (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:BICH NGOC
Middle Name:THI
Last Name:DOAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 COLTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-6351
Mailing Address - Country:US
Mailing Address - Phone:479-431-7464
Mailing Address - Fax:
Practice Address - Street 1:2214 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-6508
Practice Address - Country:US
Practice Address - Phone:479-474-5051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66257183500000X
ARPD12857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist