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Individual

DR. JACQUELINE A LUONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MEDICAL DOCTOR

Contact information

Practice address
6545 FRANCE AVE S STE 350, EDINA, MN 55435-2120
(952) 920-2600
(952) 920-2668
Mailing address
6545 FRANCE AVE S STE 350, EDINA, MN 55435-2120
(952) 920-2600
(952) 920-2668

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
40310
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1300021
MEDICA PRIMARY
MN
01
1300179
MEDICA
MN
01
151727
UCARE
MN
05
34612600
WI
01
40310
MINNESOTA LICENSE
MN
05
495527700
MN
01
548T8LU
BLUE CROSS BLUE SHIELD
MN
01
960001031243
PREFERREDONE
MN
01
HP35943
HEALTHPARTNERS
MN
01
P00263371
RAILROAD MEDICARE
MN
Enumeration date
08/30/2006
Last updated
03/11/2021
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