Healthcare Provider Details

I. General information

NPI: 1730409848
Provider Name (Legal Business Name): XIANGKE HUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SEAN HUANG M.D.

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 INNOVATION DR
JACKSON TN
38305-3019
US

IV. Provider business mailing address

PO BOX 400
JACKSON TN
38302-0400
US

V. Phone/Fax

Practice location:
  • Phone: 731-422-0213
  • Fax: 731-256-0136
Mailing address:
  • Phone: 731-423-8697
  • Fax: 731-423-2073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number50239
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number50239
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number50239
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: