Healthcare Provider Details

I. General information

NPI: 1396768222
Provider Name (Legal Business Name): XUONG T. DAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EARL K. LONG HOSPITAL, LSU UNIT 5825 AIRLINE HWY
BATON ROUGE LA
70805
US

IV. Provider business mailing address

12389 FLORIDA BLVD
BATON ROUGE LA
70815-2710
US

V. Phone/Fax

Practice location:
  • Phone: 225-358-3938
  • Fax:
Mailing address:
  • Phone: 225-272-8222
  • Fax: 225-273-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number08975R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: