Individual provider Active NPI

Eric Trung Huynh, DO

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1649633058
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
007711 Issued in AZ
Practice address
1345 E Chandler Blvd Ste 101
Phoenix, AZ 85048-6280
Phone
(480) 866-0050
Fax
(480) 866-0052
NPI assigned
Apr 2, 2016
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 007711 AZ Primary

Addresses

Primary practice location

1345 E Chandler Blvd Ste 101
Phoenix, AZ 85048-6280

Mailing address

1345 E Chandler Blvd Ste 101
Phoenix, AZ 85048-6280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912000262 AZ Practitioner - Family Practice 3870822182 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc Family Medicine CurrentSince Feb 1, 2020 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Kingman Healthcare, Inc CurrentSince Sep 1, 2019 Accepting new patients

Locations

4995 US Highway 68
Golden Valley, AZ 86413
Phone (928) 681-8500

2202 N Stockton Hill Rd
Ste 100
Kingman, AZ 86401
Phone (928) 681-8706

2202 N Stockton Hill Rd
Ste 101
Kingman, AZ 86401
Phone (628) 681-8701

2226 Hualapai Mountain Rd
Kingman, AZ 86401
Phone (928) 681-8530

2226 Hualapai Mountain Rd
Ste 101
Kingman, AZ 86401
Phone (928) 681-8530

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

3801 Santa Rosa Dr
Kingman, AZ 86401
Phone (928) 263-5000

3801 Santa Rosa Dr
Ste 400
Kingman, AZ 86401
Phone (928) 681-8530

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1649633058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E CHANDLER BLVD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850486280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E CHANDLER BLVD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850486280",
            "telephone_number": "480-866-0050",
            "fax_number": "480-866-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "ERIC",
        "middle_name": "TRUNG",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-02",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "007711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.