Provider Demographics
NPI:1679550818
Name:CHUANG, HOWARD JYI JUANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JYI JUANG
Last Name:CHUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 KNIGHT ARNOLD
Mailing Address - Street 2:#321
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-3009
Mailing Address - Country:US
Mailing Address - Phone:901-369-6090
Mailing Address - Fax:901-369-6091
Practice Address - Street 1:3960 KNIGHT ARNOLD
Practice Address - Street 2:#321
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-3009
Practice Address - Country:US
Practice Address - Phone:901-369-6090
Practice Address - Fax:901-369-6091
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000009768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00014812Medicaid
TN407111522OtherRR MCARE
AR81591OtherBCBS
TN3059332OtherBCBS
TN3672OtherTLC
TN2004126Medicaid
AR107436001OtherMCAID
TN120707OtherUNISON
AR107436001OtherMCAID
TNB02938Medicare UPIN