Provider Demographics
NPI:1518342799
Name:TIANGCO, ROSE KRISTINE DE GUZMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE KRISTINE
Middle Name:DE GUZMAN
Last Name:TIANGCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:504 CLINTON CENTER DR STE 4300
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5610
Mailing Address - Country:US
Mailing Address - Phone:601-815-2005
Mailing Address - Fax:601-815-0434
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-815-2869
Practice Address - Fax:601-815-9356
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2023-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN63576208M00000X
CT70639207R00000X
MS31380208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine