Healthcare Provider Details

I. General information

NPI: 1184716839
Provider Name (Legal Business Name): HYUN JOUNG CHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7968 ESSEN PARK
BATON ROUGE LA
70809-7439
US

IV. Provider business mailing address

633 WOODGATE BLVD
BATON ROUGE LA
70808-5443
US

V. Phone/Fax

Practice location:
  • Phone: 225-761-6700
  • Fax:
Mailing address:
  • Phone: 225-761-6741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number031241-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: