IndividualActive
Dat Phan, DO
NPI 1336995547 · Student in an Organized Health Care Education/Training Program · Keesler Afb, MS
Provider details
- NPI number
- 1336995547
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- DO
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Student, Health Care
Practice location
301 Fisher St Rm 5a127
Keesler Afb, MS 39534-2508
Phone: (228) 377-1110
Approximate (ZIP-level) locationGet directions
Mailing address
301 Fisher St Rm 5a127
Keesler Afb, MS 39534-2508
Registry dates
- Enumerated
- 2024-04-29
- Last updated
- 2024-04-29
- Certified
- 2024-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.