Provider Demographics
NPI:1063416618
Name:HAUN, LOUIS E (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:E
Last Name:HAUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1124 E WEISGARBER RD
Mailing Address - Street 2:STE 104
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2686
Mailing Address - Country:US
Mailing Address - Phone:865-584-0905
Mailing Address - Fax:865-584-3892
Practice Address - Street 1:628 SMITHVIEW DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6100
Practice Address - Country:US
Practice Address - Phone:865-984-7012
Practice Address - Fax:865-584-3892
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD08625174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3130345Medicaid
TN3130345Medicaid
TN3371152Medicare Oscar/Certification