Provider Demographics
NPI:1639135395
Name:TUN, KATHERINE MUI (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MUI
Last Name:TUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6847 MOUNTAIN VIEW RD.
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363
Mailing Address - Country:US
Mailing Address - Phone:423-910-1289
Mailing Address - Fax:423-910-1260
Practice Address - Street 1:6847 MOUNTAIN VIEW RD.
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363
Practice Address - Country:US
Practice Address - Phone:423-910-1289
Practice Address - Fax:423-910-1260
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD32073208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH21981Medicare UPIN