Provider Demographics
NPI:1346240462
Name:HUANG, LAYKOON TAN (MD MPH)
Entity Type:Individual
Prefix:
First Name:LAYKOON
Middle Name:TAN
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W INSKIP DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-4058
Mailing Address - Country:US
Mailing Address - Phone:865-687-2277
Mailing Address - Fax:865-689-5336
Practice Address - Street 1:108 W INSKIP DR
Practice Address - Street 2:SUITE B
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-4058
Practice Address - Country:US
Practice Address - Phone:865-687-2277
Practice Address - Fax:865-689-5336
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL243652083X0100X
TN9319208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3181944Medicaid
TN602003574OtherCARITEN
TN182662OtherBCBS OF TN
TN3181944Medicaid
TN1283480001Medicare NSC
B03993Medicare UPIN