Provider Demographics
NPI:1144319575
Name:HUYNH, TONG M (MD)
Entity type:Individual
Prefix:
First Name:TONG
Middle Name:M
Last Name:HUYNH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4775 JIMMY CARTER BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3760
Mailing Address - Country:US
Mailing Address - Phone:470-275-4911
Mailing Address - Fax:470-275-4918
Practice Address - Street 1:4775 JIMMY CARTER BLVD
Practice Address - Street 2:STE 201
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3760
Practice Address - Country:US
Practice Address - Phone:470-275-4911
Practice Address - Fax:770-275-4918
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-05-05
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Provider Licenses
StateLicense IDTaxonomies
GA020172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000209349JMedicaid
GA000209349JMedicaid