Organization
WILSON H LUY TAN, MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILSON H LUY TAN M.D. (PRESIDENT)
(920) 887-3460
Entity
Organization
Contact information
Practice address
705 S UNIVERSITY AVE, SUITE 380, BEAVER DAM, WI 53916-3053
(920) 887-3460
(920) 887-3491
Mailing address
705 S UNIVERSITY AVE, SUITE 380, BEAVER DAM, WI 53916-3053
(920) 887-3460
(920) 887-3491
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
28716-020
WI
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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