Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD45384 | TN |
N | 207RA0201X | Internist - Allergy & Immunology | MD0000045384 | TN |
NPI | 1891004768 |
---|---|
Provider Name | Dr. Jane Jungeon Choi |
First Address | Knoxville, TN 37919-7360 |
Second Address | Clarksville, TN 37043-5685 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2010 |
Last Update Date | 01/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103I038021 | MEDICARE (01) | TN |
1521699 | (05) | TN |