Basic Information
| Provider Information | |||||||||
| NPI: | 1194820704 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUONO | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 HOT SPRINGS BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 877013480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5054263795 | ||||||||
| FaxNumber: | 5057509017 | ||||||||
| Practice Location | |||||||||
| Address1: | 1402 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 475012122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122547310 | ||||||||
| FaxNumber: | 8122578602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 12/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 02003906B | IN | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 619878 | 01 | PA | BLUE SHIELD | OTHER | 0017578750002 | 05 | PA | MEDICAID |