Basic Information
| Provider Information | |||||||||
| NPI: | 1598415168 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAN | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | HONG | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9701 ROYSTON HWY | ||||||||
| Address2: | |||||||||
| City: | ROYSTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306624833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867466943 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300467694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783121000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2022 | ||||||||
| LastUpdateDate: | 03/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | GA | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.