Provider Demographics
NPI:1528039443
Name:CHU, VICTOR S (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:S
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1420 HIGHWAY 62 65 N
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-1959
Mailing Address - Country:US
Mailing Address - Phone:870-741-3600
Mailing Address - Fax:870-741-6800
Practice Address - Street 1:1420 HWY 62 65 N
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-1959
Practice Address - Country:US
Practice Address - Phone:870-741-3600
Practice Address - Fax:870-741-6800
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-8235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR127649001Medicaid
RIF46079Medicare UPIN
RIF46079Medicare UPIN