Individual
VIC LIENGSWANGWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1751 VETERANS DR, FLORENCE, AL 35630-4929
(256) 629-4800
(256) 629-4899
Mailing address
1701 VETERANS DR STE 190, FLORENCE, AL 35630-4928
(256) 629-4800
(256) 629-4899
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
34883
MN
2085R0001X
Radiation Oncology Physician
Primary
63950-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095514100
—
MN
01
—
1027665
PREFERRED ONE
MN
01
—
1296554
AMERICA'S PPO
MN
01
—
151702
UCARE MN
MN
01
—
2400058
MEDICA
MN
05
—
275404
—
AL
05
—
34075000
—
WI
01
—
69B76LI
BLUE CROSS BLUE SHIELD MN
MN
01
—
HP32879
HEALTHPARTNERS
MN
Enumeration date
03/14/2006
Last updated
03/11/2022
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