1215072244 NPI number — DR. GIANG T NGUYEN DPM

Table of content: DR. GIANG T NGUYEN DPM (NPI 1215072244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215072244 NPI number — DR. GIANG T NGUYEN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
GIANG
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215072244
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1021 EXECUTIVE DR
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
HIXSON
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37343-7907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-877-0050
Provider Business Mailing Address Fax Number:
423-877-7791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1021 EXECUTIVE DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
HIXSON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37343-7907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-877-0050
Provider Business Practice Location Address Fax Number:
423-877-7791
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  DPM504 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3058476 . This is a "BCBS IND. PROVIDER#" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com