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Individual

TAN D. NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA

Contact information

Practice address
97 HEFNER ST, SUITE 202, EAST ELLIJAY, GA 30540-8268
(706) 635-5177
Mailing address
145 CEDAR WOODS TRL, CANTON, GA 30114-7769
(541) 852-7719

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
912827
OR
363A00000X
Physician Assistant
Primary

Other

Enumeration date
06/01/2011
Last updated
05/12/2017
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