Healthcare Provider Details

I. General information

NPI: 1275708653
Provider Name (Legal Business Name): TRANG KIM NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV SURG ONCOLOGY
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-2280
  • Fax: 888-352-8360
Mailing address:
  • Phone: 314-362-2280
  • Fax: 888-352-8360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number2024000970
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2024000970
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: