Provider Demographics
NPI:1649019332
Name:VO, VY THI TUONG (PA-C)
Entity type:Individual
Prefix:
First Name:VY
Middle Name:THI TUONG
Last Name:VO
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 LAWRENCEVILLE SUWANEE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5483
Mailing Address - Country:US
Mailing Address - Phone:770-963-2451
Mailing Address - Fax:
Practice Address - Street 1:850 LAWRENCEVILLE SUWANEE RD STE 101
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5483
Practice Address - Country:US
Practice Address - Phone:770-963-2451
Practice Address - Fax:770-962-0017
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12535363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant