Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | MD033752E | PA |
NPI | 1295722593 |
---|---|
Provider Name | Dr. Duc Kim Hoang |
First Address | Lancaster, PA 17603-9786 |
Second Address | Lebanon, PA 17042-7529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2005 |
Last Update Date | 08/07/2007 |