Basic Information
| Provider Information | |||||||||
| NPI: | 1114346665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | LANHUONG | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 MONTLIMAR PLACE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366091794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2512073351 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 BISHOP LN N | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366085821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514504359 | ||||||||
| FaxNumber: | 2514504323 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2014 | ||||||||
| LastUpdateDate: | 06/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | DO1577 | AL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.