Provider Demographics
NPI:1174140701
Name:JI HUANG LLC
Entity type:Organization
Organization Name:JI HUANG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-878-2460
Mailing Address - Street 1:224 S WOODS MILL RD STE 370S
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3603
Mailing Address - Country:US
Mailing Address - Phone:314-878-2460
Mailing Address - Fax:314-878-2467
Practice Address - Street 1:224 S WOODS MILL RD STE 370S
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3603
Practice Address - Country:US
Practice Address - Phone:314-878-2460
Practice Address - Fax:314-878-2467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty