Provider Demographics
NPI:1609997808
Name:HUANG, JOCELIN (MD)
Entity Type:Individual
Prefix:
First Name:JOCELIN
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 FRANCE AVE S STE 610
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2144
Mailing Address - Country:US
Mailing Address - Phone:952-836-3645
Mailing Address - Fax:952-836-3646
Practice Address - Street 1:6363 FRANCE AVE S STE 610
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2144
Practice Address - Country:US
Practice Address - Phone:952-836-3645
Practice Address - Fax:952-836-3646
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN49749207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAENROLLEDMedicaid
MNP00839078OtherRAILROAD MEDICARE
MN073405100Medicaid
WI35182500Medicaid
MN073405100Medicaid