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THAO H PHAM M.D.

Allergy

Elizabethtown, Kentucky

Provider NPI: 1336140698

Provider Information:
 THAO H PHAM M.D.


Practice Location:
914 N DIXIE AVE SUITE 100 ELIZABETHTOWN, KY 42701 US
Tel: 270-765-6149  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207KA0200XPhysicians
Allergy & Immunology
Allergy
KY37275

Other Provider Identifiers:

IssuerNumberStateType
PASSPORT ADVANTAGE2649647000KY01
ANTHEM BCBS000000301574KY01
DEAH79665KY01
64062102KY05
PASSPORT HEALTH PLAN50001581KY01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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