Ky Dinh Dang, M.D
Individual provider Active NPI Family Medicine Physician · Macclenny, FL
NPI 1083723951 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083723951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME 43562 (FL)
- Practice address
- 7487 S State Road 121
Macclenny, FL 32063-5451 - Phone
- (904) 259-6211
- Fax
- (904) 259-7104
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 43562 | FL | MD | Family Medicine Physician |
| 43562 | FL | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME 43562 | FL | Yes |
Addresses
Primary practice location
7487 S State Road 121
Macclenny, FL 32063-5451
Mailing address
7487 S State Road 121
Macclenny, FL 32063-5451
Phone (904) 259-6211
Other providers in Macclenny, FL
- Stephanie Melinda Crawford
- Amber Renee Crews
- Marcheta Crews
- Gauri Rahul Dalvi
- James Timothy Damiani
- Canedra Darby
- Yola Alicja Davidson
- Nancy E Davie
- Brittany Nicole Day
- Felicia Diana Delgado
All providers in Macclenny, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.