Provider Demographics
NPI:1770514358
Name:NGUYEN, TAMMY T (OD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:NGUYEN
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6843 N ORACLE RD
Mailing Address - Street 2:STE 151
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4281
Mailing Address - Country:US
Mailing Address - Phone:520-888-0099
Mailing Address - Fax:520-888-7929
Practice Address - Street 1:6843 N ORACLE RD
Practice Address - Street 2:STE 151
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4281
Practice Address - Country:US
Practice Address - Phone:520-888-0099
Practice Address - Fax:520-888-7929
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ984189Medicaid
Z104913Medicare PIN
V06231Medicare UPIN