Provider Demographics
NPI:1164430914
Name:NGUYEN CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:NGUYEN CHIROPRACTIC, INC.
Other - Org Name:VERMILION CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TUAN-ANH NGUYEN
Authorized Official - Middle Name:DEREK
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-898-2225
Mailing Address - Street 1:1720 VETERANS MEMORIAL DR.
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510
Mailing Address - Country:US
Mailing Address - Phone:337-898-2225
Mailing Address - Fax:337-893-0253
Practice Address - Street 1:1720 VETERANS MEMORIAL DR.
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510
Practice Address - Country:US
Practice Address - Phone:337-898-2225
Practice Address - Fax:337-893-0253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1996491Medicaid
LA3307FOtherBLUE CROSS BLUE SHIELD
LA5D616Medicare ID - Type Unspecified