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General NPI Number Information
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NPI Number | 1043258247
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Entity Type | Individual
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Provider Name | LOI T VU MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 7420 GUTHRIE DR N STE 105
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City | SOUTHAVEN
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State | MS
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Zip | 38671-5857
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Country | US
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Telephone | 662-349-4321
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Fax | 662-349-3263
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Provider Business Mailing Address
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Address Line | 2527 CRANBERRY HWY
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City | WAREHAM
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State | MA
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Zip | 02571-1046
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Country | US
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Telephone | 800-841-5200
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Fax | 508-273-1351
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD028110
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 19928
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License Number State | MS
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