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DR. THAI PHAN MD NPI 1326135021


NPI Information

NPI: 1326135021
Provider Name: DR. THAI PHAN, MD
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1321 ASHLEYBROOK LN
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 659-9440
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DR. Thai Phan, MD is a specialist in Winston Salem, NC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Thai Phan, MD NPI is 1326135021. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1321 ASHLEYBROOK LN
WINSTON SALEM, NC
ZIP 27103-918
Phone: (336) 659-9440
Fax: (336) 659-9845

The NPI 1326135021 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/6/2006 and was last updated on 7/15/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P2900XPsychiatry & NeurologyPain Medicine28930NORTH CAROLINANo
2174400000XSpecialist28930NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18967433MEDICAIDNORTH CAROLINA
2C23975MEDICARE UPINNORTH CAROLINA
3209557CMEDICARE PINNORTH CAROLINA
467433OTHERNORTH CAROLINABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.