Provider Demographics
NPI:1396768222
Name:DAO, XUONG T (MD)
Entity type:Individual
Prefix:
First Name:XUONG
Middle Name:T
Last Name:DAO
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 1:12389 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-2710
Mailing Address - Country:US
Mailing Address - Phone:225-272-8222
Mailing Address - Fax:225-273-2333
Practice Address - Street 1:EARL K. LONG HOSPITAL, LSU UNIT
Practice Address - Street 2:5825 AIRLINE HWY
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805
Practice Address - Country:US
Practice Address - Phone:225-358-3938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08975R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1921556Medicaid
LA1921556Medicaid
G94834Medicare UPIN