Provider Demographics
NPI:1780686824
Name:CHUA, CORAZON NG (MD)
Entity Type:Individual
Prefix:
First Name:CORAZON
Middle Name:NG
Last Name:CHUA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:104 S FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1614
Mailing Address - Country:US
Mailing Address - Phone:606-886-8572
Mailing Address - Fax:606-886-4433
Practice Address - Street 1:2483 HIGHWAY 644 107
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230
Practice Address - Country:US
Practice Address - Phone:606-638-1154
Practice Address - Fax:606-638-4502
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY215612084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64215619Medicaid
KY1328001Medicare PIN