Doctor Name: | DR. PHUONG NGOC HUYNH |
NPI Number: | 1154486918 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 07899R |
Business Practice Address: | 4502 Highway 951 Eastern La Mental Health System Jackson, LA - 70748 |
Business Phone Number: | 2256340224 |
Business Fax Number: | 2256340213 |
Mailing Address: | 17614 Eaglewood Drive, BATON ROUGE |
State: | LA |
Postal Code: | 70810 |
Phone Number: | 2257562495 |
Fax Number: | 2252622437 |
NPI Enumeration Date: | 12/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 07899R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |