Provider Demographics
NPI:1093816233
Name:TJOA, HONG I (MD)
Entity Type:Individual
Prefix:DR
First Name:HONG
Middle Name:I
Last Name:TJOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:120 HOSPITAL DR STE 250
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-5279
Mailing Address - Country:US
Mailing Address - Phone:865-471-2570
Mailing Address - Fax:865-471-2571
Practice Address - Street 1:120 HOSPITAL DR STE 250
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-5279
Practice Address - Country:US
Practice Address - Phone:865-471-2570
Practice Address - Fax:865-471-2571
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD46765207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1522957Medicaid
MOF52309Medicare UPIN
MO110013268Medicare PIN
MO063013230Medicare PIN