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Individual

DR. KHAI T VU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
88 E MEMORIAL DR, POMEROY, OH 45769-9569
(740) 992-0060
(740) 992-5762
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 992-0060
(740) 992-5762

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34-006210
OH
207R00000X
Internal Medicine Physician
34006210
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2616440
OH
01
3618821
GROUP ORGANIZATION PTAN
OH
05
3810027007
WV
01
7412451
MEDICARE PTAN
OH
Enumeration date
02/23/2006
Last updated
01/14/2021
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