Provider Demographics
NPI:1023547957
Name:BUI, PHUOC (DPM)
Entity Type:Individual
Prefix:
First Name:PHUOC
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 COUNTRY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-5650
Mailing Address - Country:US
Mailing Address - Phone:620-803-8103
Mailing Address - Fax:
Practice Address - Street 1:216 W UNION ST STE B
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3208
Practice Address - Country:US
Practice Address - Phone:318-371-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA325701207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery