NPI 1376890293
Individual Provider
Practice location
- Address
- 307 Boatner Road Suite 114 96th Medical Group, Eglin, FL 32542
- Phone
- (850) 883-8600
Authorised official
- Name
- Chuong Nguyen Thai
- Title
- Major
- Phone
- (850) 883-9055
Registered specialties
Military Hospital
Primary
Registry record
- NPI
- 1376890293
- Entity type
- Organization
- NPI issued
- 9 Aug 2012
- Record last updated
- 14 Sep 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.