Healthcare Provider Details

I. General information

NPI: 1346240462
Provider Name (Legal Business Name): LAYKOON TAN HUANG MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W INSKIP DR SUITE B
KNOXVILLE TN
37912-4058
US

IV. Provider business mailing address

108 W INSKIP DR SUITE B
KNOXVILLE TN
37912-4058
US

V. Phone/Fax

Practice location:
  • Phone: 865-687-2277
  • Fax: 865-689-5336
Mailing address:
  • Phone: 865-687-2277
  • Fax: 865-689-5336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number24365
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number9319
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: