Healthcare Provider Details

I. General information

NPI: 1780381368
Provider Name (Legal Business Name): HUE XIONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W WISCONSIN AVE
APPLETON WI
54914-3511
US

IV. Provider business mailing address

860 FARMINGTON AVE
OSHKOSH WI
54901-1172
US

V. Phone/Fax

Practice location:
  • Phone: 920-991-1190
  • Fax:
Mailing address:
  • Phone: 920-279-4893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22067-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: