Individual
DR. RONALD A VAN TUYL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 RIVERSTONE DR, CANTON, GA 30114
(770) 345-6600
(770) 345-6611
Mailing address
215 RIVERSTONE DR, CANTON, GA 30114
(770) 345-6600
(770) 345-6611
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
030684
GA
207KA0200X
Allergy Physician
030684
GA
207Y00000X
Otolaryngology Physician
Primary
030684
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00509187D
—
GA
Enumeration date
08/09/2006
Last updated
12/11/2007
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