Provider Demographics
NPI:1003820788
Name:VUONG, HIEU
Entity Type:Individual
Prefix:DR
First Name:HIEU
Middle Name:
Last Name:VUONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:STE. 360
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4361
Mailing Address - Country:US
Mailing Address - Phone:225-293-0068
Mailing Address - Fax:225-293-0018
Practice Address - Street 1:3851 S SHERWOOD FOREST BLVD
Practice Address - Street 2:STE. 360
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4361
Practice Address - Country:US
Practice Address - Phone:225-293-0068
Practice Address - Fax:225-293-0018
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD225R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1542466Medicaid
5431260001OtherPALMETTO GBA/CIGNA GOV SERVICES
LAV71265Medicare UPIN
LA5A839Medicare ID - Type Unspecified
5431260001OtherPALMETTO GBA/CIGNA GOV SERVICES