Provider Demographics
NPI:1164613535
Name:LA, HAU TRUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:HAU
Middle Name:TRUNG
Last Name:LA
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 1:205 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-2435
Mailing Address - Country:US
Mailing Address - Phone:615-384-7500
Mailing Address - Fax:615-752-5738
Practice Address - Street 1:713B PRESIDENT PL
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5652
Practice Address - Country:US
Practice Address - Phone:615-930-2162
Practice Address - Fax:615-930-2163
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD42545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine