Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 34583-020 | WI |
N | 207RA0401X | Internist - Addiction Medicine | 40429 | KY |
NPI | 1609956838 |
---|---|
Provider Name | Tuyen T Tran |
First Address | Versailles, KY 40383-9387 |
Second Address | Lexington, KY 40515-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 25/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G03123 | (02) | WI |