Provider Demographics
NPI:1215911029
Name:VO, LOI DAI (MD)
Entity type:Individual
Prefix:
First Name:LOI
Middle Name:DAI
Last Name:VO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 W FERTITTA BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4646
Mailing Address - Country:US
Mailing Address - Phone:337-239-2606
Mailing Address - Fax:337-238-5748
Practice Address - Street 1:1017 W FERTITTA BLVD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4646
Practice Address - Country:US
Practice Address - Phone:337-239-2606
Practice Address - Fax:337-238-5748
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11402R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1663328Medicaid
LAG12325Medicare UPIN
LA5W288Medicare ID - Type Unspecified