Phuong Ngoc Huynh, MD
Individual provider Active NPI General Practice Physician · Jackson, LA
NPI 1154486918 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154486918
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 07899R (LA)
- Practice address
- 4502 Highway 951
Eastern la Mental Health System
Jackson, LA 70748 - Phone
- (225) 634-0224
- Fax
- (225) 634-0213
- NPI assigned
- Dec 22, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07899R | LA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 07899R | LA | Yes |
Addresses
Primary practice location
4502 Highway 951
Eastern la Mental Health System
Jackson, LA 70748
Mailing address
17614 Eaglewood Drive
Baton Rouge, LA 70810
Phone (225) 756-2495
Other providers in Jackson, LA
- Sarah Heiser
- Amanda Hidalgo
- Patricia Hollingworth
- Mar'Lesha Lorraine Hollins-Hills
- Brittani Hollins
- Lotacha Irvin-Hayes
- Catina Luzinda Johnson
- Paul W Jones
- Elizabeth Krupa
- Randi C Leblanc
All providers in Jackson, LA · General Practice Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.