Provider Demographics
NPI:1861594459
Name:VUONG, BILL NHUNG Q (DPM)
Entity type:Individual
Prefix:DR
First Name:BILL
Middle Name:NHUNG Q
Last Name:VUONG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1604 RAMSGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-2561
Mailing Address - Country:US
Mailing Address - Phone:423-843-9938
Mailing Address - Fax:423-843-5067
Practice Address - Street 1:260 16TH AVE
Practice Address - Street 2:SUITE 116 GENUINE PODIATRY SERVICES
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321
Practice Address - Country:US
Practice Address - Phone:423-775-5400
Practice Address - Fax:423-570-0222
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN00598213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3353628Medicaid
TNTN00598OtherLICENSE
3353628Medicare ID - Type Unspecified
U91649Medicare UPIN