Provider Demographics
NPI:1568744613
Name:VAN, FRANKY CONG (PHARMD)
Entity Type:Individual
Prefix:
First Name:FRANKY
Middle Name:CONG
Last Name:VAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14778 RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-7452
Mailing Address - Country:US
Mailing Address - Phone:225-573-3735
Mailing Address - Fax:
Practice Address - Street 1:7411 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4639
Practice Address - Country:US
Practice Address - Phone:225-928-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19141207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology