Provider Demographics
NPI:1851369920
Name:KWOK, CHUEN K (MD)
Entity Type:Individual
Prefix:
First Name:CHUEN
Middle Name:K
Last Name:KWOK
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 1:316 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-4914
Mailing Address - Country:US
Mailing Address - Phone:337-462-1400
Mailing Address - Fax:337-462-0224
Practice Address - Street 1:316 W 7TH ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-4914
Practice Address - Country:US
Practice Address - Phone:337-462-1400
Practice Address - Fax:337-462-0224
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10335R208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1989550Medicaid
LA5DM97Medicare PIN
LA1989550Medicaid