Provider Demographics
NPI:1417260951
Name:DOAN, HIEU PHUONG (HIEU DOAN OD)
Entity Type:Individual
Prefix:
First Name:HIEU
Middle Name:PHUONG
Last Name:DOAN
Suffix:
Gender:F
Credentials:HIEU DOAN OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-0185
Mailing Address - Country:US
Mailing Address - Phone:978-996-8959
Mailing Address - Fax:
Practice Address - Street 1:310 DANIEL WEBSTER HWY,
Practice Address - Street 2:SUITE 259
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-674-2503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH841152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist