Hiep Ngoc Chau, M.D.

Key facts

NPI

1871602508

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

ME 45192 (FL)

Practice address

7487 S State Road 121
Macclenny, FL 32063-5451

Phone

(904) 259-6211

Fax

(904) 259-7104

NPI assigned

Aug 29, 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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871602508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7487 SOUTH STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "32063",
            "telephone_number": "904-259-6211",
            "fax_number": "904-259-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7487 S STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635451",
            "telephone_number": "904-259-6211",
            "fax_number": "904-259-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAU",
        "first_name": "HIEP",
        "middle_name": "NGOC",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 45192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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