Provider Demographics
NPI:1316929813
Name:NGUYEN, LAM DUY (MD)
Entity type:Individual
Prefix:DR
First Name:LAM
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:
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:PO BOX 122152 DEPT 2152
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-0001
Mailing Address - Country:US
Mailing Address - Phone:337-494-2921
Mailing Address - Fax:337-494-6523
Practice Address - Street 1:1322 ELTON RD STE E
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4100
Practice Address - Country:US
Practice Address - Phone:337-824-6835
Practice Address - Fax:337-824-8741
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021553207R00000X
LAMD.021553207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1976423Medicaid
LA110247204OtherMEDICARE RAILROAD
LA5U030CE81Medicare PIN
LA5U030Medicare PIN
LA1976423Medicaid