Individual
DR. VINH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 675-7636
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200591
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1071641
—
LA
01
—
4F217F600
MEDICARE - PTAN
LA
01
—
P00418561
RAIL ROAD MEDICARE
LA
Enumeration date
05/02/2007
Last updated
04/12/2012
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