CHIACHIEN JAKE WANG (NPI# 1457615395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457615395 |
| Entity Type | Individual |
| Full Name | CHIACHIEN JAKE WANG |
| Credential | MD |
| Practice Address |
2600 Kings Hwy Shreveport LA 71103-3950 |
| Mailing Address |
Po Box 1684 Shreveport LA 71165-1684 |
| Practice Telephone | 3182124639 |
| Practice Fax Number | 3182128305 |
| Mailing Telephone | 3184244088 |
| Mailing Fax Number | 8552301466 |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2018-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
304912 | LA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | BP10047559 | TX | Student, Health Care |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CT | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5801 Forest Park Rd, Moncrief Radiation Oncology Center At Utsw, Dallas, TX 752356403 | 2146458559 |
| Street Address |
2600 KINGS HWY |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439863 | Michael Leonard Durci | Radiology | 2600 Kings Hwy, Willis Knighton Cancer Center, Shreveport, LA 71103-3950 | 2005-06-28 |
| 1922478304 | Wk Radiation Oncology Services | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-09-29 |
| 1932578820 | Amanda Lyn Hayes | Nurse Practitioner | 2600 Kings Hwy, #420, Shreveport, LA 71103-3950 | 2015-09-21 |
| 1659767127 | Sergio Jaramillo | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-04-11 |
| 1528330305 | Andrea Marie Moore | Clinical Nurse Specialist | 2600 Kings Hwy, Suite 340, Shreveport, LA 71103-3950 | 2012-02-08 |
| 1093006603 | Daniella Phuong-di Dang | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2011-04-29 |
| 1548448442 | Robin Ann Lacour | Obstetrics & Gynecology | 2600 Kings Hwy, Suite 420, Shreveport, LA 71103-3950 | 2008-02-04 |
| 1740493923 | Wk Gynecologic Oncology Clinic | Obstetrics & Gynecology | 2600 Kings Hwy, Suite 420, Shreveport, LA 71103-3950 | 2007-05-07 |
| 1306062625 | Destin R. Black | Obstetrics & Gynecology | 2600 Kings Hwy, Suite 420, Shreveport, LA 71103-3950 | 2007-04-17 |
| 1447475603 | David Bruce Carrington | Pharmacist | 2600 Kings Hwy, Suite 212, Shreveport, LA 71103-3950 | 2007-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669564258 | Radiation Oncology Services Apmc | Radiology | 2600 Kings Hwy., Shreveport, LA 71103 | 2006-09-29 |
| 1265439863 | Michael Leonard Durci | Radiology | 2600 Kings Hwy, Willis Knighton Cancer Center, Shreveport, LA 71103-3950 | 2005-06-28 |
| 1922478304 | Wk Radiation Oncology Services | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-09-29 |
| 1659767127 | Sergio Jaramillo | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2015-04-11 |
| 1093006603 | Daniella Phuong-di Dang | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2011-04-29 |
| 1770809238 | Promas LLC | Radiology | 1453 E Bert Kouns Industrial Loop, Shreveport, LA 71105 | 2010-04-08 |
| 1225258809 | Radiation Oncology St Mary Place LLC | Radiology | One Saint Mary Place, Cancer Treatment Center, Shreveport, LA 71101-4343 | 2007-04-26 |
| 1548487804 | Radiation Oncology Associates A Medical Corporation | Radiology | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2007-04-19 |
| 1578576526 | Beng-hoey Jo | Radiology | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2006-08-14 |
| 1215943642 | Sanford Rory Katz | Radiology | 2600 Kings Hwy, Shreveport, LA 71103-3950 | 2006-07-31 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.