Provider Demographics
NPI:1043258247
Name:VU, LOI T (MD)
Entity Type:Individual
Prefix:
First Name:LOI
Middle Name:T
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 CRANBERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-1046
Mailing Address - Country:US
Mailing Address - Phone:800-841-5200
Mailing Address - Fax:508-273-1351
Practice Address - Street 1:7420 GUTHRIE DR N STE 105
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-5857
Practice Address - Country:US
Practice Address - Phone:662-349-4321
Practice Address - Fax:662-349-3263
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0281102085R0202X
MS199282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR131186001Medicaid
TN3802782Medicaid
MS00117025Medicaid
MO208493304Medicaid
AR131186001Medicaid
MO208493304Medicaid