Provider Demographics
NPI:1891004768
Name:CHOI, JANE JUNGEON (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:JUNGEON
Last Name:CHOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:JUNGEON
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:STE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:298 CLEAR SKY CT
Practice Address - Street 2:STE C
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5685
Practice Address - Country:US
Practice Address - Phone:931-802-5297
Practice Address - Fax:931-401-1421
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000045384207RA0201X
TNMD45384207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I038021OtherMEDICARE
TN1521699Medicaid