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General NPI Number Information
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NPI Number | 1023547957
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Entity Type | Individual
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Provider Name | PHUOC BUI DPM
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Gender | Male
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 216 W UNION ST STE B
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City | MINDEN
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State | LA
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Zip | 71055-3208
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Country | US
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Telephone | 318-371-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 COUNTRY CLUB CIR
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City | MINDEN
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State | LA
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Zip | 71055-5650
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Country | US
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Telephone | 620-803-8103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 325701
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License Number State | LA
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