Basic Information
| Provider Information | |||||||||
| NPI: | 1629257365 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NGUYEN | ||||||||
| FirstName: | TUAN | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 S MINNESOTA AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571053762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1021 MONTGOMERY HWY STE 203 | ||||||||
| Address2: | |||||||||
| City: | VESTAVIA HILLS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352162805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059491800 | ||||||||
| FaxNumber: | 2058707735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2007 | ||||||||
| LastUpdateDate: | 09/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 8725 | SD | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 30185 | AL | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7302960 | 05 | SD | MEDICAID | P01265202 | 01 | SD | RR MEDICARE | OTHER | 120200 | 05 | AL | MEDICAID |