Individual
DR. BRIAN C. TIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
281 TRACE COLONY PARK DRIVE, SUITE A, RIDGELAND, MS 39157-3915
(601) 324-4066
Mailing address
344 SUNDIAL RD, MADISON, MS 39110-8772
(601) 984-5017
(601) 984-5042
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
23344
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06238338
—
MS
Enumeration date
07/22/2011
Last updated
07/14/2022
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