Phung Phan, D.O.
NPI 1043567407 · Family Medicine Physician · Lakeland, FL
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Phung Phan, D.O. is a Family Medicine Physician provider in Lakeland, FL (NPI 1043567407).
Provider details
- NPI number
- 1043567407
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- License
- 1141 (NE)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Other Service Providers
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (3)
- Unit 28130, Building 475Apo, AE 09114Phone: (314) 590-3176
- 3030 Harden BlvdLakeland, FL 33803-7952Phone: (863) 284-5000
- 4710 S Florida AveLakeland, FL 33813-2165Phone: (863) 284-5000
Registry dates
- Enumerated
- 2012-08-04
- Last updated
- 2024-05-30
- Certified
- 2024-05-30
Frequently asked questions
- What is Phung Phan's NPI number?
- Phung Phan's National Provider Identifier (NPI) is 1043567407, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Phung Phan's specialty?
- Phung Phan is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Phung Phan located?
- Phung Phan's practice location on file with NPPES is 1625 Shepherd Rd, Lakeland, FL 33811-2122.
- What is Phung Phan's phone number?
- The practice phone number listed in the NPPES registry for Phung Phan is (863) 284-1626.
- Does Phung Phan accept Medicare?
- Phung Phan is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Phung Phan's NPI active?
- Yes — Phung Phan's NPI (1043567407) is active in the NPPES registry as of the last update on 2024-05-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.