Wilson H Luy Tan, MD LTD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

28716-020 Issued in WI

Legal business name

WILSON H LUY TAN, MD LTD

Practice address

705 S University Ave
Suite 380
Beaver Dam, WI 53916-3053

Phone

(920) 887-3460

Fax

(920) 887-3491

NPI assigned

Sep 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wilson H Luy Tan, M.D.

Title

President

Phone

(920) 887-3460

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1134314362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "SUITE 380",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163053",
            "telephone_number": "920-887-3460",
            "fax_number": "920-887-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "SUITE 380",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163053",
            "telephone_number": "920-887-3460",
            "fax_number": "920-887-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON H LUY TAN, MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "LUY TAN",
        "authorized_official_first_name": "WILSON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-887-3460",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "28716-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Lanae Wichman
• Sean K Wiemann, PHARM D.
• Jay M Wilkins, MD
• Melodie S Willihnganz, MS CLL A
• Molly Willihnganz, MS, LMFT
• Virginia K Wilson, MD
• Ruth Ann Wimmer, RN BSN
• Kevin Wippermann
• Michelle Joan Wolff, NP
• Ashley Beth Wolosek-Raatz

• Neurology Physician in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Neurology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.