MEDICARE: CHUEN K KWOK M.D.

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	208800000X	Urology Physician	10335R	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

General Provider Information

NPI Number	:	1851369920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHUEN K KWOK M.D.

Provider Business Mailing Address
First Line	:	316 W 7TH ST
Second Line	:
City	:	DERIDDER
State	:	LA
Zip	:	70634-4914
Country	:	US
Telephone Number	:	337-462-1400
Fax Number	:	337-462-0224

Provider Business Practice Location Address
First Line	:	316 W 7TH ST
Second Line	:
City	:	DERIDDER
State	:	LA
Zip	:	70634-4914
Country	:	US
Telephone Number	:	337-462-1400
Fax Number	:	337-462-0224

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	05/20/2011

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