Provider Demographics
NPI:1366637563
Name:TRAN, AN L (MD)
Entity type:Individual
Prefix:DR
First Name:AN
Middle Name:L
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 GLENWOOD DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1130
Mailing Address - Country:US
Mailing Address - Phone:423-698-1844
Mailing Address - Fax:423-624-2226
Practice Address - Street 1:2390 N. OCOEE ST.
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:423-339-0300
Practice Address - Fax:423-709-0543
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48335207RH0003X
PAMT189067390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1528999Medicaid
GA003130708AMedicaid