Stacey Thao Phan, D.O.

General Practice Physician · Normal, IL

Individual Active NPI

NPI number 1235263385

Practice location

1300 Franklin Ave Ste 100
Normal, IL 61761-3676
Phone
(309) 268-3455
Fax
(309) 268-5620

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NPI record

NPI
1235263385
Entity type
Individual (Type 1)
Enumeration date
March 14, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X — IL

Mailing address

6801 Green Meadow Ln
Oklahoma City, OK 73132-3957
Phone
(405) 245-0747

About Dr. Phan

Stacey Thao Phan, D.O. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 1300 Franklin Ave Ste 100, Normal, IL 61761-3676. The NPI number 1235263385 was assigned on March 14, 2007 and the record was last updated on July 8, 2007.

Frequently asked questions

What is the NPI number of Stacey Thao Phan, D.O.?

The NPI number is 1235263385.

What is the phone number of Dr. Phan?

The phone number listed for the practice location is (309) 268-3455.

Where is Dr. Phan located?

1300 Franklin Ave Ste 100, Normal, IL 61761-3676.

What is the taxonomy code for Dr. Phan?

The primary taxonomy code is 208D00000X – General Practice Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.