Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | DPM.200006 | LA |
NPI | 1083660302 |
---|---|
Provider Name | Dr. David Ywjpheej Vang |
First Address | Covington, LA 70433 |
Second Address | Covington, LA 70433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 07/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1369683 | (05) | LA |
P00442320 | RAILROAD MEDICARE PTAN (01) | LA |
V09043 | (02) | LA |