Provider Demographics
NPI:1043471238
Name:SEO, HAK SOK (MD)
Entity Type:Individual
Prefix:
First Name:HAK
Middle Name:SOK
Last Name:SEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 16TH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-1036
Mailing Address - Country:US
Mailing Address - Phone:423-775-6933
Mailing Address - Fax:423-775-3372
Practice Address - Street 1:188 16TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-1036
Practice Address - Country:US
Practice Address - Phone:423-775-6933
Practice Address - Fax:423-775-3372
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA002990207R00000X
TN47543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine