Provider Demographics
NPI:1265548416
Name:VO, PHUONG T (MD)
Entity type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:T
Last Name:VO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7521 WESTBANK EXPY
Mailing Address - Street 2:SUITE E
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2300
Mailing Address - Country:US
Mailing Address - Phone:504-328-5466
Mailing Address - Fax:504-328-5469
Practice Address - Street 1:7521 WESTBANK EXPY
Practice Address - Street 2:SUITE E
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2300
Practice Address - Country:US
Practice Address - Phone:504-328-5466
Practice Address - Fax:504-328-5469
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2012-04-03
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Provider Licenses
StateLicense IDTaxonomies
LA022953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF7394OtherBLUE CROSS BLUE SHIELD
LA1498181Medicaid
LAF7394OtherBLUE CROSS BLUE SHIELD
LA5A603DP24Medicare PIN