Provider Demographics
NPI:1902082258
Name:NGUYEN, LAM D (DO)
Entity Type:Individual
Prefix:DR
First Name:LAM
Middle Name:D
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9320 S MINGO RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5710
Mailing Address - Country:US
Mailing Address - Phone:918-901-9701
Mailing Address - Fax:918-901-9702
Practice Address - Street 1:9320 S MINGO RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5710
Practice Address - Country:US
Practice Address - Phone:918-901-9701
Practice Address - Fax:918-901-9702
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK47222081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200224100AMedicaid
OKOK402096Medicare PIN