Individual provider Active NPI

Chanh Van Huynh, MD

  • Exclusive Provider Organization
  • Marked Tree, AR
National Provider Identifier
1083629489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
C6339 Issued in AR
Practice address
309 Liberty St
Marked Tree, AR 72365-2208
Phone
(870) 358-3880
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X C6339 AR Primary

Addresses

Primary practice location

309 Liberty St
Marked Tree, AR 72365-2208

Mailing address

309 Liberty St
Marked Tree, AR 72365-2208
Phone (870) 358-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C6339ARMDExclusive Provider Organization

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083629489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 LIBERTY ST",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723652208",
            "telephone_number": "870-358-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 LIBERTY ST",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723652208",
            "telephone_number": "870-358-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "CHANH",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "AR",
            "license": "C6339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marked Tree, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.