Healthcare Provider Details

I. General information

NPI: 1245206416
Provider Name (Legal Business Name): KAO BIN CHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 INDIANA AVE
FORT CAMPBELL KY
42223-6215
US

IV. Provider business mailing address

2140 BATAVIA ST
CLARKSVILLE TN
37040-7513
US

V. Phone/Fax

Practice location:
  • Phone: 270-798-6373
  • Fax: 270-798-6377
Mailing address:
  • Phone: 931-906-6100
  • Fax: 270-798-6377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberMD29087
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: