Provider Demographics
NPI:1053307041
Name:HAN, YUCHUN (MD & PHD)
Entity Type:Individual
Prefix:DR
First Name:YUCHUN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:MD & PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHATTANOOGA NEUROLOGY & HEADACHE CENTER
Mailing Address - Street 2:1626 GUNBARREL ROAD
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-698-8747
Mailing Address - Fax:423-698-8847
Practice Address - Street 1:1626 GUNBARREL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7125
Practice Address - Country:US
Practice Address - Phone:423-698-8747
Practice Address - Fax:423-698-8847
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN350532084N0400X
GA500212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00914262AMedicaid
TNH35756Medicare UPIN
TN3863640Medicare ID - Type Unspecified