Provider Demographics
NPI:1245254549
Name:CHUN, JOSEPH T (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:CHUN
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 1:1930 ALCOA HWY
Mailing Address - Street 2:SUITE 235
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1500
Mailing Address - Country:US
Mailing Address - Phone:865-544-6546
Mailing Address - Fax:865-544-6547
Practice Address - Street 1:1930 ALCOA HWY
Practice Address - Street 2:SUITE 235
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1500
Practice Address - Country:US
Practice Address - Phone:865-544-6546
Practice Address - Fax:865-544-6547
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000023442174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0144032OtherBC/BS
TN3069413Medicaid
F33463Medicare UPIN
TN3069413Medicaid