| Ktn Medical Llc | |
|
1718 N Martin Luther King Hwy Lake Charles LA 70601-1351 | |
| (337) 433-6500 | |
| Not Available |
| Full Name | Ktn Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 1718 N Martin Luther King Hwy, Lake Charles, Louisiana |
| Authorized Official Name and Position | Ken T Nguyen (OWNER) |
| Authorized Official Contact | 3374336500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ktn Medical Llc 1718 N Martin Luther King Hwy Lake Charles LA 70601-1351 Ph: () - | Ktn Medical Llc 1718 N Martin Luther King Hwy Lake Charles LA 70601-1351 Ph: (337) 433-6500 |
| NPI Number | 1396007480 |
|---|---|
| Provider Enumeration Date | 06/13/2012 |
| Last Update Date | 05/19/2021 |
| Medicare PECOS PAC ID | 4385025071 |
|---|---|
| Medicare Enrollment ID | O20220712003462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396007480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Vanchi R. Vu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265638167 PECOS PAC ID: 4385804830 Enrollment ID: I20120321000316 |
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