Provider Demographics
NPI:1043537350
Name:DANG, LIN LINH LY (MD)
Entity type:Individual
Prefix:
First Name:LIN LINH
Middle Name:LY
Last Name:DANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RUE DE LA VIE ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-5127
Mailing Address - Country:US
Mailing Address - Phone:225-201-0413
Mailing Address - Fax:
Practice Address - Street 1:500 RUE DE LA VIE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-5127
Practice Address - Country:US
Practice Address - Phone:225-201-0413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LAMD.205512207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08755550Medicaid
LA2106384Medicaid
LA356002YH3UMedicare PIN