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Individual

DR. VAN T TUONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2619 EVERGREEN WYNDE, LOUISVILLE, KY 40223-1370
(502) 254-0087
Mailing address
2619 EVERGREEN WYNDE, LOUISVILLE, KY 40223-1370

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02499
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080127646
RAILROAD MEDICARE
01
1101539
PASSPORT
01
2436295000
PASSPORT ADVANTAGE
05
64024995
KY
Enumeration date
01/02/2007
Last updated
10/06/2010
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