Provider Demographics
NPI:1285921924
Name:TIENOR, BRIAN J (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:TIENOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1719 TOWER DR W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-7512
Mailing Address - Country:US
Mailing Address - Phone:651-275-3050
Mailing Address - Fax:651-275-3027
Practice Address - Street 1:2950 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5085
Practice Address - Country:US
Practice Address - Phone:651-275-3050
Practice Address - Fax:651-275-3032
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI61500-20207W00000X, 207WX0009X
MN57335207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist