Healthcare Provider Details

I. General information

NPI: 1598262933
Provider Name (Legal Business Name): HIEP LUU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MCCONNELL DR
COLUMBUS OH
43214-3463
US

IV. Provider business mailing address

DEPT L-3652
COLUMBUS OH
43260-3652
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-5377
  • Fax: 614-533-6200
Mailing address:
  • Phone: 614-544-6366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.014217
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number34.014217
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: