Individual
DR. LAN HUU PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025590
LA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
025590
LA
208M00000X
Hospitalist Physician
025590
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04336595
—
MS
05
—
1048780
—
LA
01
—
P00244581
RAIL ROAD MEDICARE
LA
Enumeration date
10/28/2005
Last updated
06/10/2021
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