MEDICARE: DR. HIEU VUONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PD225R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5431260001	OTHER		PALMETTO GBA/CIGNA GOV SERVICES

General Provider Information

NPI Number	:	1003820788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HIEU VUONG

Provider Business Mailing Address
First Line	:	3851 S SHERWOOD FOREST BLVD
Second Line	:	STE. 360
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4361
Country	:	US
Telephone Number	:	225-293-0068
Fax Number	:	225-293-0018

Provider Business Practice Location Address
First Line	:	3851 S SHERWOOD FOREST BLVD
Second Line	:	STE. 360
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4361
Country	:	US
Telephone Number	:	225-293-0068
Fax Number	:	225-293-0018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	12/01/2009

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