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Individual

DR. VINCENT TAM NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
17520 OLD JEFFERSON HWY, STE B, PRAIRIEVILLE, LA 70769-3929
(225) 673-8983
(225) 677-8983
Mailing address
8490 PICARDY AVE, BLDG 200, BATON ROUGE, LA 70809-3731
(225) 237-1754
(225) 237-1722

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD200621
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1071005
LA
01
248568YRBU
MEDICARE PTAN
LA
Enumeration date
02/03/2007
Last updated
09/24/2014
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