| Organization Name: | KHOA CAO NGUYEN MD PA |
| NPI Number: | 1437440716 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KHOA NGUYEN (OWNER) |
| Mailing Address: | 1340 S Constitution Ave Ashdown |
| State: | AR US |
| Postal Code: | 718228652 |
| Phone Number: | 8708982007 |
| Fax Number: | |
| NPI Enumeration Date: | 04/21/2011 |
| NPI Last Update Date: | 04/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C 5496 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |