Healthcare Provider Details

I. General information

NPI: 1952415028
Provider Name (Legal Business Name): CHONA C HUANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 COOSA ST E
TALLADEGA AL
35160-2276
US

IV. Provider business mailing address

320 COOSA ST E
TALLADEGA AL
35160-2276
US

V. Phone/Fax

Practice location:
  • Phone: 256-362-3636
  • Fax:
Mailing address:
  • Phone: 256-362-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24836
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: