Provider Demographics
NPI:1710146089
Name:TO, LOAN QUYNH (MD)
Entity Type:Individual
Prefix:
First Name:LOAN
Middle Name:QUYNH
Last Name:TO
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 1:221 W TYRONE RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6500
Mailing Address - Country:US
Mailing Address - Phone:865-483-6343
Mailing Address - Fax:865-483-1185
Practice Address - Street 1:221 W TYRONE RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6500
Practice Address - Country:US
Practice Address - Phone:865-483-6343
Practice Address - Fax:865-483-1185
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47407208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics